Individual
DR. BRAD EDWARD PEZOLDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS MSD
Contact information
Practice address
1316 COFFEE RD STE D10, MODESTO, CA 95355-3191
(209) 524-2988
Mailing address
4320 ALSACE LN, MODESTO, CA 95356-8945
(209) 524-2988
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
41206
CA
Other
Enumeration date
01/02/2007
Last updated
08/11/2009
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