Individual
MIRA YANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDHAP
Contact information
Practice address
10373 GILLIAM DR, ELK GROVE, CA 95757-3512
(916) 502-7252
Mailing address
10373 GILLIAM DR, ELK GROVE, CA 95757-3512
(916) 502-7252
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
23678
CA
124Q00000X
Dental Hygienist
Primary
HAP954
CA
Other
Enumeration date
04/16/2020
Last updated
08/10/2023
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