Individual
MARY ELIZABETH TIMOTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
95TH MEDICAL GROUP SGDH, 30 NIGHTINGALE RD, EDWARDS AFB, CA 93524-1760
(661) 277-2872
(661) 277-4728
Mailing address
9137 HOLLY AVE, CALIFORNIA CITY, CA 93505-2806
(760) 373-2049
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
20888
CA
Other
Enumeration date
11/08/2006
Last updated
07/08/2007
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