Individual
JILLIAN ELIZABETH CHURCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH, OMT
Contact information
Practice address
675 CAMINO DE LOS MARES, SAN CLEMENTE, CA 92673-2835
(949) 230-9931
Mailing address
26762 CALLE MARIA, CAPO BEACH, CA 92624-1527
(949) 230-9931
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
30833
CA
Other
Enumeration date
09/07/2024
Last updated
09/07/2024
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