Individual
MR. YONATHAN GAMBOA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
966 W MARIPOSA AVE, STOCKTON, CA 95204-3017
(209) 643-9420
Mailing address
966 W MARIPOSA AVE, STOCKTON, CA 95204-3017
(209) 643-9420
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
CA
Other
Enumeration date
12/31/2020
Last updated
12/31/2020
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