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Organization
NORTH VALLEY DENTAL
Active
Organization
NORTH VALLEY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE N PEDERSEN D.D.S. (OWNER)
(707) 447-1010
Entity
Organization
Contact information
Practice address
770 MASON ST STE 110, VACAVILLE, CA 95688-4648
(707) 447-1010
Mailing address
770 MASON ST STE 110, VACAVILLE, CA 95688-4648
(707) 447-1010
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
31510
CA
122300000X
Dentist
64725
CA
Other
Enumeration date
11/02/2016
Last updated
11/02/2016
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