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MARY ALI DDS

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1952391393

Individual Registrant:
 MARY  ALI DDS
Gender: F
Not Sole Proprietor

Location and contact information for practice:
525 S FAIRMONT AVE SUITE H LODI, CA 95240 US
Tel: 209-369-2696  Fax: 209-369-6743

Contact information for business:
525 S FAIRMONT AVE SUITE H LODI, CA 95240 US
Tel: 209-369-2696  Fax: 209-369-6743

Registration Information:
NPI: 1952391393
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
CA50201

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
DEABA806497501




HEALTH CARE JOBS CA - Page 1



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