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SHELLY MARIE AZEVEDO RDH

>> Dental Hygienist >> Dental Providers

Registrant NPI Number: 1174021661

Individual Registrant:
 SHELLY MARIE AZEVEDO RDH
Gender: F
Sole Proprietor

Location and contact information for practice:
311 W OAK ST  LODI, CA 95240-3401 US
Tel: 209-327-2446  Fax: --

Contact information for business:
311 W OAK ST  LODI, CA 95240-3401 US
Tel: 209-327-2446  Fax: --

Registration Information:
NPI: 1174021661
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y124Q00000XDental Providers
Dental Hygienist
CA11388

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS CA - Page 1



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