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General NPI Number Information
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NPI Number | 1063118552
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Entity Type | Organization
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Legal Business Name | RAMOS DENTAL, PC
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Dates
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Enumeration Date | 02/06/2023
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Last Update Date | 02/06/2023
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Provider Practice Location Address
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Address Line | 1111 SONOMA AVE STE 102
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City | SANTA ROSA
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State | CA
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Zip | 95405-4813
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Country | US
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Telephone | 707-544-4611
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Fax |
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Provider Business Mailing Address
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Address Line | 1111 SONOMA AVE STE 102
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City | SANTA ROSA
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State | CA
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Zip | 95405-4813
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Country | US
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Telephone | 707-544-4611
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | CHERYL WILLETT
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Credential | DDS
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Telephone | 707-544-4611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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