Individual
MRS. JODI RAE BURDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.A.
Contact information
Practice address
1370 CHORRO ST, SAN LUIS OBISPO, CA 93401-4006
(805) 543-6535
(805) 543-6879
Mailing address
PO BOX 4669, PASO ROBLES, CA 93447-4669
(805) 674-3767
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
04332
CA
Other
Enumeration date
11/02/2006
Last updated
07/08/2007
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