Individual
LISA GILDEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDHAP
Contact information
Practice address
701 E CHANNEL ST, STOCKTON, CA 95202-2628
(209) 601-5705
Mailing address
4726 SAINT ANDREWS DR, STOCKTON, CA 95219-1915
(209) 601-5705
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
HAP748
CA
Other
Enumeration date
02/07/2020
Last updated
05/23/2024
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