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Individual

JENNIFER VAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
10882 CEDAR STREET, STANTON, CA 90680
(714) 365-6739
Mailing address
10882 CEDAR STREET, STANTON, CA 90680

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
27562
CA
124Q00000X
Dental Hygienist
Primary
RDHAP 628
CA

Other

Enumeration date
10/01/2015
Last updated
09/10/2016
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