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Individual

TANYA VELAZQUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
2735 N BLACKSTONE AVE, FRESNO, CA 93703-1705
(559) 225-3391
(559) 225-1601
Mailing address
12442 RAILROAD DR, CUTLER, CA 93615-2127

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
27210
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
27210
RDH
CA
Enumeration date
01/15/2013
Last updated
01/15/2013
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