Santa Rosa Dental
Dentist, General Practice in Santa Rosa, CA. Organization (NPI-2).
NPI number1043309727
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1043309727
- Entity type
- Organization (NPI-2)
- Legal business name
- Santa Rosa Dental
- Organization subpart
- No
- Enumeration date
- Oct 12, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 30068 | CA | Yes |
| 1223G0001X | Dentist, General Practice | 30433 | CA | |
| 1223G0001X | Dentist, General Practice | 30461 | CA |
Other names
- Dinu A Gray, DDS/Myrna Menjivar Gray,dds/Eugene Field,dds (Doing Business As)
Practice location
2360 Mendocino AveSuite A 6
Santa Rosa, CA 95403-3153
Phone 707-568-1436 · Fax 707-568-1483
Mailing address
188 Stanford AveMill Valley, CA 94941-3546
Phone 415-389-9566 · Fax 415-389-9563
Authorized official
Myrna Menjivar Gray
Partner
4152999566
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