Individual
STEPHANIE ELIZABETH GORDILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDHAP
Contact information
Practice address
606 RUBY RD, LIVERMORE, CA 94550-5146
(510) 703-5357
Mailing address
606 RUBY RD, LIVERMORE, CA 94550-5146
(510) 703-5357
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
HAP835
CA
Other
Enumeration date
05/17/2021
Last updated
05/17/2021
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