Provider Demographics
NPI:1326203811
Name:NAVARRO, ISAAC R (DMD)
Entity Type:Individual
Prefix:DR
First Name:ISAAC
Middle Name:R
Last Name:NAVARRO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 EAST CENTER AVE.
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-6331
Mailing Address - Country:US
Mailing Address - Phone:559-727-4700
Mailing Address - Fax:559-727-4782
Practice Address - Street 1:12586 AVE. 408
Practice Address - Street 2:
Practice Address - City:OROSI
Practice Address - State:CA
Practice Address - Zip Code:93647-9454
Practice Address - Country:US
Practice Address - Phone:559-528-2804
Practice Address - Fax:559-528-7623
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57304122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA57304OtherDENTAL LICENSE