Individual
EDGAR DONES ROQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
420 W SHIELDS AVE, FRESNO, CA 93705-4107
(559) 412-4702
(559) 473-1475
Mailing address
420 W SHIELDS AVE, FRESNO, CA 93705-4107
(559) 412-4702
(559) 473-1475
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
55681
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55681
DOCTORS LICENSE
CA
Enumeration date
08/20/2007
Last updated
11/17/2010
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