Individual
ANTONIA M EBNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDHAP
Contact information
Practice address
863 I ST STE B, LOS BANOS, CA 93635-4310
(209) 826-5990
(209) 826-6268
Mailing address
863 I ST STE B, LOS BANOS, CA 93635-4310
(209) 826-5990
(209) 826-6268
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
RDHAP3
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
YO1864
DENTI CAL
CA
Enumeration date
02/12/2008
Last updated
02/12/2008
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