Organization
CONSOLIDATED TRIBAL HEALTH PROJECT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ANN NMN GONZALEZ (CLINI DIRECTORC)
(707) 485-5115
Entity
Organization
Contact information
Practice address
6991 N STATE ST, REDWOOD VALLEY, CA 95470-9629
(707) 485-5115
Mailing address
PO BOX 387, CALPELLA, CA 95418-0387
(707) 485-5115
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
31614
CA
Other
Enumeration date
07/18/2006
Last updated
08/22/2020
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