Provider First Line Business Practice Location Address:
WESTERN DENTAL/ BRIDENT 150BFO
Provider Second Line Business Practice Location Address:
3077 W SHAW AVE
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93711
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-490-1327
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/16/2019