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2360 Mendocino Ave Suite A 6 Santa Rosa CA 95403-3153 | |
(707) 568-1436 | |
(707) 568-1483 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 2360 Mendocino Ave, Santa Rosa, California |
Authorized Official Name and Position | Myrna Menjivar Gray (PARTNER) |
Authorized Official Contact | 4152999566 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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188 Stanford Ave Mill Valley CA 94941-3546 Ph: (415) 389-9566 | 2360 Mendocino Ave Suite A 6 Santa Rosa CA 95403-3153 Ph: (707) 568-1436 |
NPI Number | 1043309727 |
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Provider Enumeration Date | 10/12/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1043309727 | NPI | - | NPPES |
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