Individual
KIMBERLY ANN BRASIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9663 OLD REDWOOD HWY, PENNGROVE, CA 94951-9610
(707) 548-2789
Mailing address
9663 OLD REDWOOD HWY, PENNGROVE, CA 94951-9610
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
HAP669
CA
Other
Enumeration date
01/23/2018
Last updated
01/23/2018
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