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Individual

MRS. LUISA M JENKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
2151 E PALMDALE BLVD, PALMDALE, CA 93550-4037
(661) 575-0009
Mailing address
45074 10TH ST W, SUITE 109, LANCASTER, CA 93534-2371
(661) 940-7000

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
14984
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14984
REGISTERED DENTAL HYGIENIST
CA
Enumeration date
09/23/2011
Last updated
09/23/2011
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