Individual
OMAR CALVILLO MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1175 HART ST, YUMA, AZ 85369
(909) 927-2831
Mailing address
1ST DNBN ATTN: CREDENTIALS BOX 555221, OCEANSIDE, CA 92055-5221
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
AZ
Other
Enumeration date
12/10/2020
Last updated
12/10/2020
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