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General NPI Number Information
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NPI Number | 1598561714
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Entity Type | Organization
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Legal Business Name | BERNSTEIN AND WANDELL, A DENTAL CORPORATION
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Dates
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Enumeration Date | 02/19/2025
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 1791 MARLOW RD STE 9
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City | SANTA ROSA
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State | CA
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Zip | 95401-4112
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Country | US
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Telephone | 479-970-6493
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Fax |
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Provider Business Mailing Address
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Address Line | 2245 MONTGOMERY DR
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City | SANTA ROSA
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State | CA
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Zip | 95405-4900
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Country | US
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Telephone | 479-970-6493
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAEL BERNSTEIN
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Credential | DDS
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Telephone | 479-970-6493
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number |
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License Number State |
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