Provider Demographics
NPI:1912604950
Name:CELESTE DENTAL INC.
Entity Type:Organization
Organization Name:CELESTE DENTAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMINDER
Authorized Official - Middle Name:K
Authorized Official - Last Name:PANDHER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:209-765-6929
Mailing Address - Street 1:1601 MCHENRY VILLAGE WAY STE 1
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-4338
Mailing Address - Country:US
Mailing Address - Phone:209-765-6929
Mailing Address - Fax:
Practice Address - Street 1:1308 CELESTE DR STE 1
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-2402
Practice Address - Country:US
Practice Address - Phone:209-765-6929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty