Organization
REDWOOD EMPIRE SURGERY CENTER, INC
Active
Parent organization
PEDIATRIC DENTAL INITIATIVE OF THE NORTH COAST, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEDIATRIC DENTAL INITIATIVE OF THE NORTH COAST, INC.
Authorized official
MS. JULIE BELLE TUCKER RN (ADMINISTRATOR/DIRECTOR OF NURSING)
(707) 838-6560
Entity
Organization
Contact information
Practice address
1380 19TH HOLE DR, WINDSOR, CA 95492-7713
(707) 838-6560
(707) 838-8464
Mailing address
1380 19TH HOLE DR, WINDSOR, CA 95492-7713
(707) 838-6560
(707) 838-8464
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
05/04/2007
Last updated
03/23/2009
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