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Individual

JESSICA BAISLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1300 N DUTTON AVE, SANTA ROSA, CA 95401-0058
(707) 396-5151
Mailing address
3375 PARKGATE CT, RICHMOND, CA 94806-1989
(510) 367-0744

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
104711
CA

Other

Enumeration date
04/26/2019
Last updated
07/30/2023
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