| Petaluma Dental Group | |
|
1430 E Washington St Petaluma CA 94954-3631 | |
| (707) 762-0067 | |
| (707) 762-4782 |
| Full Name | Petaluma Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1430 E Washington St, Petaluma, California |
| Authorized Official Name and Position | Debra A Quackenbush (OFFICE MANAGER) |
| Authorized Official Contact | 7077620067 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Petaluma Dental Group 1430 E Washington St Petaluma CA 94954-3631 Ph: (707) 762-0067 | Petaluma Dental Group 1430 E Washington St Petaluma CA 94954-3631 Ph: (707) 762-0067 |
| NPI Number | 1275776684 |
|---|---|
| Provider Enumeration Date | 04/15/2009 |
| Last Update Date | 04/15/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275776684 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 44612 (California) | Primary |
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