| Dinu A Gray/myrna Menjivar Gray | |
|
701 Sonoma Mountain Pkwy Suite E 1 Petaluma CA 94954-8518 | |
| (707) 782-0789 | |
| (707) 782-9133 |
| Full Name | Dinu A Gray/myrna Menjivar Gray |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 701 Sonoma Mountain Pkwy, Petaluma, California |
| Authorized Official Name and Position | Myrna Menjivar (PARTNER) |
| Authorized Official Contact | 4152999566 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dinu A Gray/myrna Menjivar Gray 188 Stanford Ave Mill Valley CA 94941-3546 Ph: (415) 389-9566 | Dinu A Gray/myrna Menjivar Gray 701 Sonoma Mountain Pkwy Suite E 1 Petaluma CA 94954-8518 Ph: (707) 782-0789 |
| NPI Number | 1356438311 |
|---|---|
| Provider Enumeration Date | 10/09/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356438311 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 30461 (California) | Primary |
| 1223G0001X | Dentist - General Practice | 30433 (California) | Secondary |
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