Organization
CHILDREN'S DENTISTRY AND ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE OHARA DDS, MSD (PRESIDENT)
(559) 554-9999
Entity
Organization
Contact information
Practice address
6245 N FRESNO ST STE 103, FRESNO, CA 93710-5270
(559) 554-9999
Mailing address
6245 N FRESNO ST STE 103, FRESNO, CA 93710-5270
(559) 554-9999
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
11/26/2014
Last updated
08/25/2016
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