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Individual

CHRISTINA M VIDAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
200 W SHAW, 110, CLOVIS, CA 93612
(559) 325-6161
Mailing address
5140 E KING CANYON, FRESNO, CA 93727
(559) 248-6663

Taxonomy

Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
62632
CA

Other

Enumeration date
12/18/2008
Last updated
01/12/2009
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