Individual
STACI BILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDHAP
Contact information
Practice address
4021 CALLE ABRIL, SAN CLEMENTE, CA 92673-2603
(949) 230-5763
Mailing address
4021 CALLE ABRIL, SAN CLEMENTE, CA 92673-2603
(949) 230-5763
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
RDHAP 356
CA
Other
Enumeration date
07/18/2011
Last updated
07/18/2011
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