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Organization
WAYNE KODAMA DDS
Active
Organization
WAYNE KODAMA DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN KODAMA (MANAGER)
(559) 229-3201
Entity
Organization
Contact information
Practice address
1275 W SHAW AVE STE 101, FRESNO, CA 93711-3710
(559) 229-3201
Mailing address
1275 W SHAW AVE STE 101, FRESNO, CA 93711-3710
(559) 229-3201
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
38861
CA
Other
Enumeration date
06/09/2015
Last updated
06/09/2015
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