Organization
VISALIA DENTISTRY 4 KIDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD T CANADA DDSMS (PRESIDENT)
(559) 733-4470
Entity
Organization
Contact information
Practice address
3912 W CALDWELL AVE, VISALIA, CA 93277-9249
(559) 733-4470
(559) 733-0817
Mailing address
3912 W CALDWELL AVE, VISALIA, CA 93277-9249
(559) 733-4470
(559) 733-0817
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
38812
CA
Other
Enumeration date
03/11/2014
Last updated
03/11/2014
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