# AMIR HOSSEINI DENTAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Petaluma Braces and Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477177616
- **Authorized official:** SEYED AMIR M HOSSEINI (CEO)
- **Authorized official phone:** (707) 787-5600

## Contact information

- **Practice address:** 26 4TH ST STE C, PETALUMA, CA 94952-3477
- **Practice address phone:** (707) 787-5600
- **Practice address fax:** (707) 787-5602
- **Mailing address:** 26 4TH ST STE C, PETALUMA, CA 94952-3477
- **Mailing address phone:** (707) 787-5600

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | — | — |

## Other

- **Enumeration date:** 06/03/2020
- **Last updated:** 06/05/2020