| NPI | 1215438130 |
|---|---|
| Doing Business As | MODESTO SMILES DENTISTRY DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | MICHAEL J LOPEZ Owner 209-245-0014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2018-02-26 |
| Last Update Date | 2022-02-04 |