Individual
MRS. JENNIFER K AZEVEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA, OSA
Contact information
Practice address
201 E ORANGEBURG AVE STE A, MODESTO, CA 95350-5355
(209) 527-5050
(209) 527-0659
Mailing address
201 E. ORANGEBURG AVE, SUITE A, MODESTO, CA 95350
(209) 527-5050
(209) 527-0659
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
RDS77618
CA
Other
Enumeration date
10/09/2017
Last updated
10/09/2017
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