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Organization
IMAGE DENTAL
Active
Organization
IMAGE DENTAL
Active
Other names
Stephen Nozaki DDS, INC
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN N NOZAKI DDS (OWNER)
(209) 955-1500
Entity
Organization
Contact information
Practice address
3453 BROOKSIDE RD, SUITE A, STOCKTON, CA 95219-1788
(209) 955-1500
(209) 955-1697
Mailing address
3453 BROOKSIDE RD, SUITE A, STOCKTON, CA 95219-1788
(209) 955-1500
(209) 955-1697
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
57165
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57165
DDS
CA
Enumeration date
10/14/2012
Last updated
10/14/2012
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