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Individual

ERIN MCCOLLUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
16126 CRENSHAW BLVD, GARDENA, CA 90249-4834
(310) 515-5505
(310) 515-2760
Mailing address
16126 CRENSHAW BLVD, GARDENA, CA 90249-4834
(310) 515-5505
(310) 515-2760

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
30554
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30554
CA
Enumeration date
11/09/2016
Last updated
11/09/2016
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