Organization
ALIRAAD MOATTAR DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI-RAAD MOATTAR DDS (OWNER DENTIST)
(707) 546-7905
Entity
Organization
Contact information
Practice address
3748 MONTGOMERY DR, SANTA ROSA, CA 95405-5215
(707) 546-7905
(707) 546-1573
Mailing address
3748 MONTGOMERY DR, SANTA ROSA, CA 95405-5215
(707) 546-7905
(707) 546-1573
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59502
DENTIST
CA
Enumeration date
05/18/2021
Last updated
05/18/2021
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