Individual
STEPHANIE RAQUEL MACIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
258 CAMPODONICO AVE, GUADALUPE, CA 93434-1502
(805) 266-5738
Mailing address
258 CAMPODONICO AVE, GUADALUPE, CA 93434-1502
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
D5899160
CA
Other
Enumeration date
03/09/2026
Last updated
03/09/2026
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