Petaluma Dental Group

LBN: Mangrum Dental Corporation
Petaluma Dental Group is an health care organization with primary practice located at 1430 E Washington St , Petaluma CA 94954-3631. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Mangrum Dental Corporation can be contacted via phone (707) 762-0067, or through Quackenbush, Debra A via phone (707) 762-0067.

Contact Information

Primary practice address
1430 E Washington St Petaluma CA 94954-3631
Phone: (707) 762-0067
Fax: (707) 762-4782
Website:
Map and Directions
Authorized official contact:
Name: Quackenbush, Debra A
Phone: (707) 762-0067

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 44612 California

Profile Details

NPI number 1275776684
LBN Legal business name Mangrum Dental Corporation
DBA Doing business as Petaluma Dental Group
Authorized official Quackenbush, Debra A
Entity Organization
Organization subpart 1 No
Enumeration date Apr 15th, 2009
Last updated Apr 15th, 2009 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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