NPI | 1427660695 |
---|---|
Doing Business As | FOUNTAINGROVE DENTISTRY |
Entity Type | Organization |
Authorized Contact | ROBERT ERLACH Part Owner 707-525-1500 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2020-08-19 |
Last Update Date | 2020-08-19 |