Provider First Line Business Practice Location Address:
533 W MELINDA AVE
Provider Second Line Business Practice Location Address:
MOBILE DENYAL HYGIENE PRACTICE
Provider Business Practice Location Address City Name:
PORTERVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93257-6670
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-623-1870
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/27/2006