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Organization
FAREID DENTAL CORPORATION
Active
Organization
FAREID DENTAL CORPORATION
Active
Other names
Packwood Creek Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BEVAN S FAREID DDS (OWNER)
(559) 732-1953
Entity
Organization
Contact information
Practice address
4129 S MOONEY BLVD, SUITE B, VISALIA, CA 93277-9147
(559) 732-1953
(559) 732-1983
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
(714) 845-8890
(949) 474-1495
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/26/2014
Last updated
03/08/2022
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