Provider Demographics
NPI:1093988503
Name:FIELD, EUGENE G (DDS)
Entity Type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:G
Last Name:FIELD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3260 MENDOCINO AVE
Mailing Address - Street 2:SUITE A-6
Mailing Address - City:SANTA-ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403
Mailing Address - Country:US
Mailing Address - Phone:707-568-1436
Mailing Address - Fax:707-568-1483
Practice Address - Street 1:2360 MENDOCINO AVE
Practice Address - Street 2:SUIT A-6
Practice Address - City:SANTA-ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403
Practice Address - Country:US
Practice Address - Phone:707-568-1436
Practice Address - Fax:707-568-1483
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30068122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist