Individual
MICHELLE MANCILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
45104 10TH ST W, LANCASTER, CA 93534-2310
(661) 942-2391
(661) 902-6839
Mailing address
45104 10TH ST WEST, LANCASTER, CA 93534
(661) 942-2391
(661) 902-6839
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
A8922473
CA
Other
Enumeration date
07/18/2014
Last updated
07/18/2014
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