Mangrum Dental Corporation
Mangrum Dental Corporation provides General Practice Dentistry in Petaluma, California. Licensed in California. Registered with an NPI since 2009.
- Licensed in
- CA
- In the registry since
- 2009
Practice location Address checks out
1430 E Washington StPetaluma, CA 94954-3631 Not confirmed with CMS for 17 years — call before visiting
Phone: (707) 762-0067
Fax: (707) 762-4782
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| General Practice Dentistry (primary) | Taxonomy 1223G0001X · Licence 44612 (CA) |
|---|
Record details
| NPI number | 1275776684 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Debra Quackenbush — Office Manager · (707) 762-0067 |
| Other names | Petaluma Dental Group |
| NPI enumerated | April 15, 2009 |
| Last updated in NPPES | April 15, 2009 |
| Mailing address | 1430 E Washington St, Petaluma, CA 94954-3631 |
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