Provider Demographics
NPI:1013311489
Name:T. GARY FORESTER, D.D.S., INC.
Entity Type:Organization
Organization Name:T. GARY FORESTER, D.D.S., INC.
Other - Org Name:FORESTER DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FRONT OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-432-1300
Mailing Address - Street 1:7525 N CEDAR AVE STE 117
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2689
Mailing Address - Country:US
Mailing Address - Phone:559-432-1300
Mailing Address - Fax:559-439-0313
Practice Address - Street 1:7525 N CEDAR AVE STE 117
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2689
Practice Address - Country:US
Practice Address - Phone:559-432-1300
Practice Address - Fax:559-439-0313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-14
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26758122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty