| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 8741 Brooks Rd S, Windsor, California |
| Authorized Official Name and Position | Cynthia J Russo (DIRECTOR OF FINANCE) |
| Authorized Official Contact | 7072305602 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8741 Brooks Rd S Windsor CA 95492-7853 Ph: () - | 8741 Brooks Rd S Windsor CA 95492 Ph: (707) 575-0600 |
| NPI Number | 1104163815 |
|---|---|
| Provider Enumeration Date | 01/15/2013 |
| Last Update Date | 08/28/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104163815 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 46245 (California) | Primary |
Mohammed Alroshaidan, Dds, A Professional Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6580 Hembree Ln Ste 255, Windsor, CA 95492 Phone: 707-836-1202 Fax: 707-836-1253 | |
Mark J. Hagele, Dds, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1380 19th Hole Dr, Windsor, CA 95492 Phone: 707-838-6560 | |
Tadesse Tesfamichael, Dds, A Professional Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6580 Hembree Ln Ste 255, Windsor, CA 95492 Phone: 707-836-1202 | |