Provider Demographics
NPI:1699475228
Name:TASKER AND ROWAN DENTAL CORPORATION OF MARIN
Entity type:Organization
Organization Name:TASKER AND ROWAN DENTAL CORPORATION OF MARIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JEANNINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SASO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-633-1322
Mailing Address - Street 1:PO BOX 961
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95759-0961
Mailing Address - Country:US
Mailing Address - Phone:916-633-1322
Mailing Address - Fax:
Practice Address - Street 1:7428 REDWOOD BLVD STE 101
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-2419
Practice Address - Country:US
Practice Address - Phone:415-879-5566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental