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Organization

RINCON FAMILY DENTAL

Active
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Organization

RINCON FAMILY DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GERRET W OSENDORF DDS (OWNER/DENTIST)
(707) 523-7423
Entity
Organization

Contact information

Practice address
55 ELAINE DR, SANTA ROSA, CA 95409-4248
(707) 523-7423
Mailing address
55 ELAINE DR, SANTA ROSA, CA 95409-4248
(707) 523-7423

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
56052
—
1223P0300X
Periodontics
—
—

Other

Enumeration date
06/13/2013
Last updated
06/13/2013
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