| Santa Rosa Pediatric Dentistry | |
|
515 Farmers Ln Santa Rosa CA 95405-4917 | |
| (714) 717-0364 | |
| Not Available |
| Full Name | Santa Rosa Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 515 Farmers Ln, Santa Rosa, California |
| Authorized Official Name and Position | Amber Michelle Nierode (PEDIATRIC DENTIST) |
| Authorized Official Contact | 7147170364 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Santa Rosa Pediatric Dentistry 515 Farmers Ln Santa Rosa CA 95405-4917 Ph: (714) 717-0364 | Santa Rosa Pediatric Dentistry 515 Farmers Ln Santa Rosa CA 95405-4917 Ph: (714) 717-0364 |
| NPI Number | 1477080901 |
|---|---|
| Provider Enumeration Date | 05/15/2017 |
| Last Update Date | 07/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477080901 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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