DR. Jiries Peter Mogannam, D.D.S., M.D. is an oral and maxillofacial surgery dentist in Santa Rosa, CA. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. DR. Jiries Peter Mogannam, D.D.S., M.D. NPI is 1609056878. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
1111 SONOMA AVE
SUITE #220
SANTA ROSA, CA
ZIP 95405-819
Phone: (707) 566-7300
The NPI 1609056878 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).
The enumeration date for this NPI number is 11/5/2007 and was last updated on 8/17/2011.