| Vintage Dental | |
|
2937 Veneman Ave Ste A201 Modesto CA 95356-0681 | |
| (209) 524-5044 | |
| (209) 524-5064 |
| Full Name | Vintage Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2937 Veneman Ave Ste A201, Modesto, California |
| Authorized Official Name and Position | Ray Richard Rodig (OWNER PRESIDENT) |
| Authorized Official Contact | 2095245044 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vintage Dental 2937 Veneman Ave Ste A201 Modesto CA 95356-0681 Ph: (209) 524-5044 | Vintage Dental 2937 Veneman Ave Ste A201 Modesto CA 95356-0681 Ph: (209) 524-5044 |
| NPI Number | 1396963633 |
|---|---|
| Provider Enumeration Date | 04/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396963633 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 31851 (California) | Primary |
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