Individual
BERENICE PENA MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
535 BODEGA CT, MERCED, CA 95340-0714
(209) 928-5400
Mailing address
19969 GREENLEY RD STE CANDD, SONORA, CA 95370-5908
(209) 532-0034
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
34551
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124286885
ORGANIZATION
CA
Enumeration date
01/09/2023
Last updated
01/09/2023
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