Individual
KHRYSTAL AUDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
155 N FRESNO ST, FRESNO, CA 93701-2302
(559) 459-4182
Mailing address
155 N FRESNO ST, FRESNO, CA 93701-2302
(559) 459-4182
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DDS106155
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/15/2020
Last updated
03/24/2022
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