Organization · Type 2 NPI

Gill Dalla Dental Inc

Dental Clinic/Center · Lodi, CA

NPI number 1609403021 Active

Practice location

601 W Kettleman Ln
Lodi, CA 95240-6006

Specialties and licenses

Taxonomy	Code	License
Dental Clinic/Center Primary	261QD0000X	None listed

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NPI record

NPI: 1609403021
Entity type: Organization (Type 2)
Issued: Mar 25, 2020
Last updated: Jul 1, 2020
Status: Active

Other names

<unavail>
Modern Dental and Implants · doing business as
Modern Dental and Implants · doing business as

Authorized official

Dr. Devan Dalla, DDS
CEO
(646) 427-6519

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About NPI 1609403021

Gill Dalla Dental Inc's National Provider Identifier is 1609403021, issued on Mar 25, 2020. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Lodi, CA. The record was last updated on Jul 1, 2020.