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Organization
FRESNO ORAL MAXILLOFACIAL SURGERY AND DENTAL IMPLANT CENTER
Active
Organization
FRESNO ORAL MAXILLOFACIAL SURGERY AND DENTAL IMPLANT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN SMITH (DIRECTOR OF OPERATIONS)
(559) 326-5932
Entity
Organization
Contact information
Practice address
1903 E FIR AVE STE 101, FRESNO, CA 93720-3862
(559) 226-2722
(559) 226-6989
Mailing address
1903 E FIR AVE STE 101, FRESNO, CA 93720-3862
(559) 226-2722
(559) 226-6989
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
09/22/2006
Last updated
05/14/2021
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