Individual
SHARON PROVENZANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1000 VALE TERRACE DR, VISTA, CA 92084-5218
(760) 631-5000
(760) 414-3885
Mailing address
1000 VALE TERRACE DR, VISTA, CA 92084-5218
(760) 631-5000
(760) 414-3885
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
18857
CA
Other
Enumeration date
03/03/2022
Last updated
07/01/2023
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