Provider Demographics
NPI:1639736762
Name:OZDER DENTAL CORPORATION
Entity Type:Organization
Organization Name:OZDER DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
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 1:1330 SHAW AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-3985
Mailing Address - Country:US
Mailing Address - Phone:661-202-0454
Mailing Address - Fax:
Practice Address - Street 1:1330 SHAW AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-3985
Practice Address - Country:US
Practice Address - Phone:661-202-0454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-23
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty