Organization
TASKER & ROWAN DENTAL CORPORATION OF MODESTO
Active
Other names
Champion Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
JEN SASO (EXECUTIVE MANAGER)
(916) 479-3432
Entity
Organization
Contact information
Practice address
4101 TULLY RD STE 401, MODESTO, CA 95356-8982
(209) 575-5888
Mailing address
PO BOX 961, ELK GROVE, CA 95759-0961
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
07/11/2022
Last updated
07/11/2022
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