Individual
LORENA SANTODOMINGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
BLDG 210735 C STREET, CAMP PENDLETON, CA 92055
(760) 725-2569
Mailing address
PO BOX 555221, CAMP PENDLETON, CA 92055-5221
(361) 537-4305
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
21784
CA
Other
Enumeration date
10/02/2020
Last updated
10/02/2020
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