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Roni Dawn Douglas, DDS Valid NPI

Individual provider · General Practice Dentistry · San Rafael, CA

NPI
1598873432
Type
Individual (Type 1)
Primary specialty
General Practice Dentistry (Dentist)
Specialty group
Dental Providers
Taxonomy code
1223G0001X
License number
31030 (CA)
Sex
Female
Sole proprietor
Yes
Enumerated
2006-08-29
Last updated
2007-07-08
Practice location
920 Northgate Dr, Suite 4
San Rafael, CA 94903-3429
(415) 491-1662

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