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Organization
FREMONT HEALTH CENTER DENTAL GROUP
Active
Organization
FREMONT HEALTH CENTER DENTAL GROUP
Active
Parent organization
FREMONT HEALTH CENTER DENTAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
FREMONT HEALTH CENTER DENTAL GROUP
Authorized official
MISS KELLY PIPPENGER (O.M)
(209) 463-2345
Entity
Organization
Contact information
Practice address
2043 E FREMONT ST STE 1, STOCKTON, CA 95205-5000
(209) 463-2345
(209) 463-1432
Mailing address
2043 E FREMONT ST STE 1, STOCKTON, CA 95205-5000
(209) 463-2345
(209) 463-1432
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D37743
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G89962-01
DENTICAL
—
Enumeration date
07/20/2007
Last updated
07/16/2008
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