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Organization
TEJAS MODI DDS INC
Active
Organization
TEJAS MODI DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEJAS MODI (PRESIDENT)
(951) 657-1203
Entity
Organization
Contact information
Practice address
75 W NUEVO RD STE A&B, PERRIS, CA 92571
(951) 657-1203
Mailing address
75 W. NUEVO RD, SUITE A & B, PERRIS, CA 92571-0801
(951) 657-1203
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D36129
CA
122300000X
Dentist
D43182
CA
122300000X
Dentist
D50823
CA
122300000X
Dentist
D54136
CA
1223G0001X
General Practice Dentistry
Primary
D 47131
CA
Other
Enumeration date
07/19/2007
Last updated
08/22/2018
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