| NPI | 1205262664 |
|---|---|
| Doing Business As | PETALUMA MODERN DENTISTRY DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | AMARDEEP K GILL Owner 707-789-9600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2013-09-17 |
| Last Update Date | 2013-09-17 |