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Organization
PETALUMA VALLEY DENTAL
Active
Organization
PETALUMA VALLEY DENTAL
Active
Other names
Dinu A Gray/Myrna Menjivar Gray
Organization subpart
No
Provider details
NPI number
Authorized official
MYRNA MENJIVAR DDS (PARTNER)
(415) 299-9566
Entity
Organization
Contact information
Practice address
701 SONOMA MOUNTAIN PKWY, SUITE E 1, PETALUMA, CA 94954-8518
(707) 782-0789
(707) 782-9133
Mailing address
188 STANFORD AVE, MILL VALLEY, CA 94941-3546
(415) 389-9566
(415) 389-9563
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
30433
CA
1223G0001X
General Practice Dentistry
Primary
30461
CA
Other
Enumeration date
10/09/2006
Last updated
08/22/2020
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