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421 E Cotati Ave Cotati CA 94931-4000 | |
| (707) 664-1200 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 421 E Cotati Ave, Cotati, California |
| Authorized Official Name and Position | Julia Jazmin Peo (OWNER/PRESIDENT) |
| Authorized Official Contact | 7076641200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
421 E Cotati Ave Cotati CA 94931-4000 Ph: (707) 664-1200 | 421 E Cotati Ave Cotati CA 94931-4000 Ph: (707) 664-1200 |
| NPI Number | 1457677734 |
|---|---|
| Provider Enumeration Date | 04/12/2010 |
| Last Update Date | 04/12/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457677734 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 42104 (California) | Primary |