| Permalla Dental Care | |
|
855 Lakeville St Suite 101 Petaluma CA 94952-7328 | |
| (707) 773-1234 | |
| Not Available |
| Full Name | Permalla Dental Care |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 855 Lakeville St, Petaluma, California |
| Authorized Official Name and Position | Praveena Permalla (PRESIDENT) |
| Authorized Official Contact | 7077731234 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Permalla Dental Care 855 Lakeville St Suite 101 Petaluma CA 94952-7328 Ph: (707) 773-1234 | Permalla Dental Care 855 Lakeville St Suite 101 Petaluma CA 94952-7328 Ph: (707) 773-1234 |
| NPI Number | 1356654594 |
|---|---|
| Provider Enumeration Date | 07/16/2010 |
| Last Update Date | 07/16/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356654594 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 54953 (California) | Primary |
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