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Organization
OLOPH K. GRANATH, DDS, INC.
Active
Organization
OLOPH K. GRANATH, DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TARA KELLY-GRANATH (SECRETARY)
(707) 528-9411
Entity
Organization
Contact information
Practice address
2345 4TH ST, SANTA ROSA, CA 95404-3259
(707) 528-9411
(707) 528-7101
Mailing address
2345 4TH ST, SANTA ROSA, CA 95404-3259
(707) 528-9411
(707) 528-7101
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
32309
CA
Other
Enumeration date
08/03/2011
Last updated
08/03/2011
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