Individual
MARLYN BETANCOURT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDHAP
Contact information
Practice address
85529 BRENDA LN, COACHELLA, CA 92236-4004
(760) 902-7456
Mailing address
1335 PATRICIA AVE, SIMI VALLEY, CA 93065-2812
(760) 902-7456
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
22854
CA
124Q00000X
Dental Hygienist
Primary
774
CA
Other
Enumeration date
03/06/2020
Last updated
03/06/2020
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