Individual
THERESA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3538 BOUGAINVILLE RD, SAN DIEGO, CA 92155-5491
(619) 437-2954
Mailing address
3538 BOUGAINVILLE RD, SAN DIEGO, CA 92155-5491
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Enumeration date
02/03/2021
Last updated
02/03/2021
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