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Individual

MIGUEL PADILLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
1404 MITCHELL RD, MODESTO, CA 95351-4901
(209) 537-7878
Mailing address
2331 ELM AVE, MODESTO, CA 95358-1626
(209) 765-3191

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
63257
CA
1223P0221X
Pediatric Dentistry
Primary
63257
CA

Other

Enumeration date
02/10/2014
Last updated
04/10/2019
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