NPI 1124342654

Sally Landis, RDA

Practitioner Dental Assistant San Rafael, CA

Practice location

Address: 411 4th St, San Rafael, CA 94901-5716
Phone: (415) 473-5450
Fax: (415) 473-5460

Registered specialties

Dental Assistant Primary

Dental Providers Taxonomy 126800000X Licence 39958 (CA)

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Registry record

NPI: 1124342654
Entity type: Individual
Sex (as registered): Female
NPI issued: 26 Mar 2010
Record last updated: 26 Mar 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.