# REDWOOD EMPIRE SURGERY CENTER, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PEDIATRIC DENTAL INITIATIVE OF THE NORTH COAST, INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1881806453
- **Legal business name:** PEDIATRIC DENTAL INITIATIVE OF THE NORTH COAST, INC.
- **Authorized official:** MS. JULIE BELLE TUCKER RN (ADMINISTRATOR/DIRECTOR OF NURSING)
- **Authorized official phone:** (707) 838-6560

## Contact information

- **Practice address:** 1380 19TH HOLE DR, WINDSOR, CA 95492-7713
- **Practice address phone:** (707) 838-6560
- **Practice address fax:** (707) 838-8464
- **Mailing address:** 1380 19TH HOLE DR, WINDSOR, CA 95492-7713
- **Mailing address phone:** (707) 838-6560
- **Mailing address fax:** (707) 838-8464

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/04/2007
- **Last updated:** 03/23/2009