Organization
SANTA ROSA COMMUNITY HEALT CENTERS
Active
Organization
SANTA ROSA COMMUNITY HEALT CENTERS
Active
Other names
Santa Rosa Community Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
GABRIELA BERNAL-LEROI CEO (CHIEF EXECUTIVE OFFICER)
(707) 303-3600
Entity
Organization
Contact information
Practice address
1110 N DUTTON AVE, SANTA ROSA, CA 95401-4606
(707) 303-3600
(707) 396-5155
Mailing address
3569 ROUND BARN CIR, SANTA ROSA, CA 95403-5781
(707) 303-3600
(707) 396-5155
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
12/24/2013
Last updated
12/09/2022
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