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1922193838
JARED R FORTMAN
SANTA ROSA, CA
NPI
1922193838
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223E0200X Dentist, Endodontics
(Licence: CA 51826)
Enumeration Date
2006-10-04
Last Update Date
2008-08-05
Business Address
-- JARED R FORTMAN DDS
1100 SONOMA AVE STE B
SANTA ROSA, CA 95405
Phone number: 707-527-9170
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Mailing Address
-- JARED R FORTMAN DDS
1100 SONOMA AVE STE B
SANTA ROSA, CA 95405
Phone number: 707-527-9170
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