Organization
ROLAND I. YOUNG, DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROLAND IAN YOUNG D.D.S. (OWNER/DOCTOR)
(209) 522-9963
Entity
Organization
Contact information
Practice address
1316 COFFEE RD STE E14, MODESTO, CA 95355-3191
(209) 522-9963
(209) 522-5184
Mailing address
1316 COFFEE RD STE E14, MODESTO, CA 95355-3191
(209) 522-9963
(209) 522-5184
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
29538
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B29538-01
—
CA
Enumeration date
08/19/2008
Last updated
08/19/2008
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