Agbottah, Elom Kwame

Agbottah, Elom Kwame is an individual health care provider with primary practice located at 2225 Plaza Pkwy , Modesto CA 95350-6215. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice. Dental Providers / General Practice is his primary health care specialty. Agbottah, Elom Kwame can be contacted via phone (209) 491-3620.

Contact Information

Primary practice address
2225 Plaza Pkwy Modesto CA 95350-6215
Phone: (209) 491-3620
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 33911 Texas
Dental Providers / General Practice 1223G0001X 103776 California

Profile Details

NPI number 1326531120
LBN Legal business name Agbottah, Elom Kwame
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2018
Last updated Oct 2nd, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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