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Organization

SOE L. WYNN, DMD, INC.

Active
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Organization

SOE L. WYNN, DMD, INC.

Active
Other names
Allstar Family Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SOE LWIN WYNN DMD (PRESIDENT)
(209) 238-9444
Entity
Organization

Contact information

Practice address
2030 COFFEE RD, SUITE C-4, MODESTO, CA 95355-2413
(209) 238-9444
(209) 238-9446
Mailing address
2030 COFFEE ROAD, SUITE C-4, MODESTO, CA 95355-8425
(209) 238-9444
(209) 238-9446

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
45058
CA

Other

Enumeration date
04/03/2007
Last updated
06/11/2008
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