| NPI | 1316406309 |
|---|---|
| Doing Business As | SANTA ROSA PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | CHERYL WILLETT Treasurer 707-527-8509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2023-02-20 |