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Organization
ELLEFSON & MARELICH DENTAL CORPORATION
Active
Organization
ELLEFSON & MARELICH DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA DAVID ELLEFSON DMD (DENTIST)
(707) 527-0363
Entity
Organization
Contact information
Practice address
1100 SONOMA AVE, SUITE A, SANTA ROSA, CA 95405
(707) 527-0363
(707) 527-6735
Mailing address
1100 SONOMA AVE, SUITE A, SANTA ROSA, CA 95405
(707) 527-0363
(707) 527-6735
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DDS100710
CA
1223G0001X
General Practice Dentistry
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Other
Enumeration date
09/07/2017
Last updated
09/07/2017
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