Organization
GUY W MENDIVIL DDS PROFESSIONAL DENTAL CORP
Active
Other names
Bakersfield Orthodontic Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GUY W MENDIVIL DDS (OWNER)
(661) 323-5910
Entity
Organization
Contact information
Practice address
515 W COLUMBUS ST STE AB, BAKERSFIELD, CA 93301-5846
(661) 323-5910
Mailing address
515 W COLUMBUS ST STE AB, BAKERSFIELD, CA 93301-5846
(661) 323-5910
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D29737
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
170062
CGP
CA
01
—
G9391401
DENTI-CAL
CA
Enumeration date
01/30/2007
Last updated
06/22/2015
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