# GREATER MODESTO DENTAL IMPLANT &ORAL SURGERY CENTER

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326468752
- **Authorized official:** VICTORIA BRUNO (ADMINISTRATOR)
- **Authorized official phone:** (209) 527-5050

## Contact information

- **Practice address:** 201 E ORANGEBURG AVE, SUITE A, MODESTO, CA 95350-5355
- **Practice address phone:** (209) 527-5050
- **Practice address fax:** (209) 527-0659
- **Mailing address:** 201 E ORANGEBURG AVE, SUITE A, MODESTO, CA 95350-5355
- **Mailing address phone:** (209) 527-5050
- **Mailing address fax:** (209) 527-0659

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 32447 | CA | Yes |

## Other

- **Enumeration date:** 04/24/2014
- **Last updated:** 07/01/2016