| Hillcrest Dental Group | |
|
511 Hayes Ln. Petaluma CA 94952 | |
| (707) 763-2654 | |
| (707) 763-3141 |
| Full Name | Hillcrest Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 511 Hayes Ln., Petaluma, California |
| Authorized Official Name and Position | Leah Deberardinis (PRESIDENT/ TREASURER) |
| Authorized Official Contact | 7077632654 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hillcrest Dental Group 511 Hayes Ln Petaluma CA 94952-4011 Ph: (707) 763-2654 | Hillcrest Dental Group 511 Hayes Ln. Petaluma CA 94952 Ph: (707) 763-2654 |
| NPI Number | 1316969496 |
|---|---|
| Provider Enumeration Date | 07/24/2006 |
| Last Update Date | 09/08/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316969496 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 51523 (California) | Primary |
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