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Individual

MR. GREGORY BLAKE APOSTLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
95 MONTGOMERY DR, #210, SANTA ROSA, CA 95404
(707) 542-4746
(707) 544-7041
Mailing address
95 MONTGOMERY DR, #210, SANTA ROSA, CA 95404
(707) 542-4746
(707) 544-7041

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
42114
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
42114
DENTAL LIC NUMBER
CA
Enumeration date
09/07/2006
Last updated
07/08/2007
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