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Organization
KIDS 2 DENTIST FRESNO, LLC
Active
Organization
KIDS 2 DENTIST FRESNO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY LEE LANIER (MEMBER)
(323) 461-9942
Entity
Organization
Contact information
Practice address
460 E SHAW AVE, FRESNO, CA 93710-7602
(323) 203-2564
Mailing address
5449 HOLLYWOOD BLVD STE A, LOS ANGELES, CA 90027-3454
(323) 203-2564
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
01/11/2022
Last updated
01/11/2022
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