Organization
COLUMBIA-ARORA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT FLOYD WILSON JR. RDA (RDA DENTAL ASST)
(707) 765-7234
Entity
Organization
Contact information
Practice address
599 TOMALES RD, PETALUMA, CA 94952-5002
(707) 765-7234
Mailing address
6490 FRONT ST, #207, FORESTVILLE, CA 95436-9604
(707) 765-7234
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
RDA47476
CA
Other
Enumeration date
11/01/2006
Last updated
08/22/2020
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