Provider Demographics
NPI:1912319864
Name:LORETTA Y SAY, DMD INC
Entity Type:Organization
Organization Name:LORETTA Y SAY, DMD INC
Other - Org Name:LORETTA Y SAY, DMD INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DMD
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORETTA
Authorized Official - Middle Name:YOUNG
Authorized Official - Last Name:SAY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:209-358-1501
Mailing Address - Street 1:325 E BELLEVUE RD
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301-2306
Mailing Address - Country:US
Mailing Address - Phone:209-358-1501
Mailing Address - Fax:209-358-6498
Practice Address - Street 1:325 E BELLEVUE RD
Practice Address - Street 2:
Practice Address - City:ATWATER
Practice Address - State:CA
Practice Address - Zip Code:95301-2306
Practice Address - Country:US
Practice Address - Phone:209-358-1501
Practice Address - Fax:209-358-6498
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LORETTA Y SAY, DMD INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23700261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental