Individual
DR. BASHAR REYAD ELMOMANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3025 MCHENRY AVE STE N, MODESTO, CA 95350-1449
(209) 527-3990
Mailing address
3025 MCHENRY AVE STE N, MODESTO, CA 95350-1449
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
104847
CA
Other
Enumeration date
11/30/2021
Last updated
11/30/2021
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