| Roland I. Young, DDS, Inc. | |
|
1316 Coffee Rd Ste E14 Modesto CA 95355-3191 | |
| (209) 522-9963 | |
| (209) 522-5184 |
| Full Name | Roland I. Young, DDS, Inc. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1316 Coffee Rd Ste E14, Modesto, California |
| Authorized Official Name and Position | Roland Ian Young (OWNER/DOCTOR) |
| Authorized Official Contact | 2095229963 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roland I. Young, DDS, Inc. 1316 Coffee Rd Ste E14 Modesto CA 95355-3191 Ph: (209) 522-9963 | Roland I. Young, DDS, Inc. 1316 Coffee Rd Ste E14 Modesto CA 95355-3191 Ph: (209) 522-9963 |
| NPI Number | 1710134085 |
|---|---|
| Provider Enumeration Date | 08/19/2008 |
| Last Update Date | 08/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710134085 | NPI | - | NPPES |
| B29538-01 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 29538 (California) | Primary |
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