NPI | 1477080901 |
---|---|
Doing Business As | SANTA ROSA PEDIATRIC DENTISTRY |
Entity Type | Organization |
Authorized Contact | AMBER MICHELLE NIERODE Pediatric Dentist 714-717-0364 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
Enumeration Date | 2017-05-15 |
Last Update Date | 2022-07-14 |