Jeff Bertheola, DDS Valid NPI
Individual provider · General Practice Dentistry · Fort Bragg, CA
- NPI
- 1679194906
- Type
- Individual (Type 1)
- Primary specialty
- General Practice Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223G0001X
- License number
- 30702 (CA)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2020-04-27
- Last updated
- 2020-04-27
Practice location
825 Sequoia Cir
Fort Bragg, CA 95437-5422
(707) 964-0242