Individual
JOSUE EMANUEL MENJIVAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDH
Contact information
Practice address
150 TEJAS PL, NIPOMO, CA 93444-9123
(805) 929-3254
(805) 929-6359
Mailing address
150 TEJAS PL, NIPOMO, CA 93444-9123
(805) 929-3254
(805) 929-6359
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
RDH34547
CA
Other
Enumeration date
03/09/2022
Last updated
03/09/2022
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