Dr. Jimena Gomez
Dentist, General Practice in Santa Maria, CA. Individual provider (NPI-1).
NPI number1164065413
StatusActive
Last updated in NPPESOct 18, 2019
Details
- NPI
- 1164065413
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jimena Gomez
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 18, 2019
- Last updated
- Oct 18, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 103596 | CA | Yes |
Practice location
620 W Main StSanta Maria, CA 93458-5035
Phone 805-922-7725
Mailing address
620 W Main StSanta Maria, CA 93458-5035
Phone 805-922-7725
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