| Soco Dental Specialty Group | |
|
1301 Medical Center Dr Ste B Rohnert Park CA 94928-2902 | |
| (707) 978-2077 | |
| Not Available |
| Full Name | Soco Dental Specialty Group |
|---|---|
| Speciality | Dentist |
| Location | 1301 Medical Center Dr Ste B, Rohnert Park, California |
| Authorized Official Name and Position | Jamie Sahouria (PRESIDENT) |
| Authorized Official Contact | 7079782077 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Soco Dental Specialty Group 1301 Medical Center Dr Ste B Rohnert Park CA 94928-2902 Ph: (707) 978-2077 | Soco Dental Specialty Group 1301 Medical Center Dr Ste B Rohnert Park CA 94928-2902 Ph: (707) 978-2077 |
| NPI Number | 1699195800 |
|---|---|
| Provider Enumeration Date | 04/27/2014 |
| Last Update Date | 04/27/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699195800 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 53480 (California) | Primary |
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