Cottonwood Dental Care

Organization Active NPI Dentist · Cottonwood, CA

NPI 1154829224 · NPPES record last updated Jan 24, 2018

Key facts

NPI
1154829224
Entity type
Organization (NPI type 2)
Primary specialty
Dentist 122300000X
License
D43003 (CA)
Legal business name
COTTONWOOD DENTAL CARE
Practice address
3251 Chestnut Street
Cottonwood, CA 96022
Phone
(530) 347-4636
Fax
(530) 547-1871
NPI assigned
Jan 24, 2018
Organization subpart
No

Authorized official

Name
Bruce Farrell, DDS
Title
Dentist
Phone
(530) 547-5744

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Cottonwood Dental Care (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist
Group: 193400000X SINGLE SPECIALTY GROUP
122300000X D43003 CA Yes

Addresses

Primary practice location

3251 Chestnut Street
Cottonwood, CA 96022

Mailing address

PO Box 1649
Cottonwood, CA 96022-1649
Phone (530) 347-4636

Other providers in Cottonwood, CA

All providers in Cottonwood, CA · Dentist in California

Sources for this page

Verify at the official NPI Registry.