Individual
RENA BAINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
2301 ST. PAULS WAY, MODESTO, CA 95355-3390
(209) 578-4153
(209) 578-0725
Mailing address
2301 ST. PAULS WAY, MODESTO, CA 95355-3390
(209) 578-4153
(209) 578-0725
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
43683
CA
Other
Enumeration date
07/30/2006
Last updated
07/08/2007
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