Individual
MISS AMANDA M LOURENCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH, COMT
Contact information
Practice address
1476 W HERNDON AVE STE 101, FRESNO, CA 93711-4401
(559) 978-5413
Mailing address
1476 W HERNDON AVE STE 101, FRESNO, CA 93711-4401
(559) 978-5413
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
28715
CA
Other
Enumeration date
11/30/2021
Last updated
11/30/2021
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