Individual
MRS. ELMEZEN OLIVERIO MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDHAP
Contact information
Practice address
1281 CRAIG AVE, LAKEPORT, CA 95453-5704
(707) 245-6859
(707) 263-3625
Mailing address
1281 CRAIG AVE, P.O. BOX 23, LAKEPORT, CA 95453-5704
(707) 245-6859
(707) 263-3625
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
RDHAP281
CA
Other
Enumeration date
02/23/2010
Last updated
02/23/2010
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