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General NPI Number Information
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NPI Number | 1740688464
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Entity Type | Organization
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Legal Business Name | PAJORO VALLEY CHILDREN'S
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Dates
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Enumeration Date | 12/11/2014
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Last Update Date | 12/11/2014
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Provider Practice Location Address
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Address Line | 230 GREEN VALLEY RD
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City | FREEDOM
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State | CA
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Zip | 95019-3136
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Country | US
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Telephone | 831-722-9202
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Fax |
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Provider Business Mailing Address
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Address Line | 230 GREEN VALLEY RD
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City | FREEDOM
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State | CA
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Zip | 95019-3136
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Country | US
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Telephone | 831-722-9202
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. JOSEPH RAWLINS
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Credential | D.D.S.
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Telephone | 916-474-1045
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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 | 56958
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License Number State | CA
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