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751 Lombardi Ct Santa Rosa CA 95407 | |
| (707) 547-2221 | |
| (707) 547-2230 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 751 Lombardi Ct, Santa Rosa, California |
| Authorized Official Name and Position | Donald Wayne Anderson (DIRECTOR-REIMBURSEMENT ADMINISTRATI) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
751 Lombardi Ct Santa Rosa CA 95407-6793 Ph: (707) 547-2221 | 751 Lombardi Ct Santa Rosa CA 95407 Ph: (707) 547-2221 |
| NPI Number | 1730214131 |
|---|---|
| Provider Enumeration Date | 02/23/2007 |
| Last Update Date | 08/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730214131 | NPI | - | NPPES |
| G9048301 | Other | CA | MEDI-CAL PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 110000501 (California) | Primary |
Western Dental Services, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1144 Sonoma Ave Ste 108, Santa Rosa, CA 95405 Phone: 707-523-2399 Fax: 707-523-1411 | |
Stephanie Settimi Dds, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2798 Yulupa Ave Ste 3, Santa Rosa, CA 95405 Phone: 707-542-7299 |