Individual
TAMMI LYNN ACERES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1455 E 3RD ST, SAN BERNARDINO, CA 92408
(909) 382-7120
Mailing address
1454 E 2ND ST, SAN BERNARDINO, CA 92408-0118
(909) 382-7120
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
14309
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14309
STATE LICENSE NUMBER
CA
Enumeration date
04/26/2007
Last updated
07/08/2007
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