Individual
TAMMY L BONENFANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
150 TEJAS PL, NIPOMO, CA 93444-9123
(805) 938-0935
Mailing address
150 TEJAS PL, NIPOMO, CA 93444-9123
(805) 938-0935
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
RDH 18476
CA
Other
Enumeration date
07/14/2006
Last updated
07/08/2007
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