Individual
GUY WILLIAM MENDIVIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11901 BOLTHOUSE DR STE 200, BAKERSFIELD, CA 93311-8456
(661) 323-5910
(661) 323-5911
Mailing address
11901 BOLTHOUSE DR STE 200, BAKERSFIELD, CA 93311-8456
(661) 323-5910
(661) 323-5911
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D29737
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CGP170062
—
CA
01
—
D629737
DELTA DENTAL PREFIX ID
CA
05
—
G93914-01
—
CA
Enumeration date
01/05/2007
Last updated
01/02/2024
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