Provider Demographics
NPI:1679666895
Name:SOFT TOUCH DENTAL
Entity type:Organization
Organization Name:SOFT TOUCH DENTAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAEDH
Authorized Official - Middle Name:S
Authorized Official - Last Name:ALHWADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-725-0905
Mailing Address - Street 1:1120 OLIVEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348
Mailing Address - Country:US
Mailing Address - Phone:209-725-0905
Mailing Address - Fax:209-725-0904
Practice Address - Street 1:1120 OLIVEWOOD DR
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348
Practice Address - Country:US
Practice Address - Phone:209-725-0905
Practice Address - Fax:209-725-0904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51080122300000X
CA482171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered122300000XDental ProvidersDentistGroup - Multi-Specialty
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG9278101OtherDENTI CAL