Provider Demographics
NPI:1437814803
Name:OZDER DENTAL CORPORATION
Entity Type:Organization
Organization Name:OZDER DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NECDET
Authorized Official - Middle Name:
Authorized Official - Last Name:OZDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:559-255-1122
Mailing Address - Street 1:1530 E GOLDEN VALLEY WAY
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93730-3587
Mailing Address - Country:US
Mailing Address - Phone:559-475-0357
Mailing Address - Fax:
Practice Address - Street 1:1010 SHAW AVE STE B
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-3950
Practice Address - Country:US
Practice Address - Phone:559-323-1776
Practice Address - Fax:559-323-4301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental