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Individual

GAIL BROCKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
637 MERCED ST, NEWMAN, CA 95360-1070
(209) 862-0270
(209) 862-0274
Mailing address
737 W CHILDS AVE, MERCED, CA 95341-6805
(209) 385-5481
(209) 383-1296

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
5129
CA

Other

Enumeration date
06/23/2014
Last updated
06/23/2014
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