Healthcare Provider Details
I. General information
NPI: 1689597395
Provider Name (Legal Business Name): NATALIE GOLDSTONE DDS DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1144 SONOMA AVE STE 118
SANTA ROSA CA
95405-4812
US
IV. Provider business mailing address
1144 SONOMA AVE STE 118
SANTA ROSA CA
95405-4812
US
V. Phone/Fax
- Phone: 707-545-7811
- Fax:
- Phone: 707-545-7811
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NATALIE
GOLDSTONE
Title or Position: OWNER
Credential:
Phone: 707-888-4495