| Kenneth J. Bauer, Dds, A Professional Corporation | |
|
55 Mission Cir Ste 107 Santa Rosa CA 95409-5372 | |
| (707) 538-1086 | |
| (707) 538-0934 |
| Full Name | Kenneth J. Bauer, Dds, A Professional Corporation |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 55 Mission Cir Ste 107, Santa Rosa, California |
| Authorized Official Name and Position | Kenneth Bauer (PRESIDENT) |
| Authorized Official Contact | 7077991228 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth J. Bauer, Dds, A Professional Corporation 55 Mission Cir Ste 107 Santa Rosa CA 95409-5372 Ph: (707) 538-1086 | Kenneth J. Bauer, Dds, A Professional Corporation 55 Mission Cir Ste 107 Santa Rosa CA 95409-5372 Ph: (707) 538-1086 |
| NPI Number | 1114650207 |
|---|---|
| Provider Enumeration Date | 07/06/2022 |
| Last Update Date | 07/06/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114650207 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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