| NPI | 1477177616 |
|---|---|
| Doing Business As | PETALUMA BRACES AND FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | SEYED AMIR M HOSSEINI CEO 707-787-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-06-03 |
| Last Update Date | 2020-06-05 |