Individual
MELANIE WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.H.A.P.
Contact information
Practice address
1177 PALM ST, SAN LUIS OBISPO, CA 93401-3113
(805) 549-7873
Mailing address
1177 PALM ST, SAN LUIS OBISPO, CA 93401-3113
(805) 549-7873
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
400
CA
Other
Enumeration date
03/28/2012
Last updated
10/09/2012
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