| 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 |