Individual
MARTHA ELAINE TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
6114 MOHICAN DR, MANTECA, CA 95336-2519
(209) 823-4737
Mailing address
6114 MOHICAN DR, MANTECA, CA 95336-2519
(209) 823-4737
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
RDA45748
CA
Other
Enumeration date
09/14/2006
Last updated
07/08/2007
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