Individual
JACQUELINE ROSE MANCILLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
36065 SANTA FE AVE, FORT HOOD, TX 76544-5060
(254) 288-8888
Mailing address
1103 CARLSBERG DR APT A, KILLEEN, TX 76549-7298
(775) 512-9111
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Enumeration date
10/01/2025
Last updated
10/01/2025
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