| NPI | 1164407870 |
|---|---|
| Doing Business As | SANTA ROSA DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | KURT PRIESSMAN Accounting And Budget Officer 520-295-2427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| 124Q00000X Dental Hygienist | |
| 126800000X Dental Assistant | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2020-08-22 |