| Suryamanga.d.achyuta,dds,inc | |
|
1372 N Mcdowell Blvd Suite#b-1 Petaluma CA 94954-1179 | |
| (707) 778-9993 | |
| Not Available |
| Full Name | Suryamanga.d.achyuta,dds,inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1372 N Mcdowell Blvd, Petaluma, California |
| Authorized Official Name and Position | Suryamanga D Achyuta (DENTIST) |
| Authorized Official Contact | 7077789993 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Suryamanga.d.achyuta,dds,inc 1372 N Mcdowell Blvd Suite#b-1 Petaluma CA 94954-1179 Ph: (707) 778-9993 | Suryamanga.d.achyuta,dds,inc 1372 N Mcdowell Blvd Suite#b-1 Petaluma CA 94954-1179 Ph: (707) 778-9993 |
| NPI Number | 1104001015 |
|---|---|
| Provider Enumeration Date | 01/09/2008 |
| Last Update Date | 01/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104001015 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 51889 (California) | Primary |
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