Organization
LANCE C. BAUTISTA DDS, INC.
Active
Other names
Dr. Lance C. Bautista Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
LANCE C. BAUTISTA DDS (CEO, PRESIDENT)
(209) 523-5437
Entity
Organization
Contact information
Practice address
1213 COFFEE RD STE E, MODESTO, CA 95355-4229
(209) 523-5437
(209) 523-5436
Mailing address
1213 COFFEE RD STE E, MODESTO, CA 95355-4229
(209) 523-5437
(209) 523-5436
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
04/16/2019
Last updated
04/16/2019
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