Individual
GINA A VANDERHORST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
52 S MAIN ST, ANGELS CAMP, CA 95222
(209) 754-6262
Mailing address
PO BOX 939, ANGELS CAMP, CA 95222-0939
(209) 754-6254
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
RDH18003
CA
Other
Enumeration date
08/30/2019
Last updated
08/30/2019
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