Gardner, Mary Katheryn

Gardner, Mary Katheryn is an individual health care provider with primary practice located at 18515 Mansel Ave , Redondo Beach CA 90278-4642. She recently has only one registered license in Dental Providers / Dental Assistant, which is considered as her primary health care specialty. Gardner, Mary Katheryn can be contacted via phone (310) 507-5756.

Contact Information

Primary practice address
18515 Mansel Ave Redondo Beach CA 90278-4642
Phone: (310) 507-5756
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Assistant 126800000X 68677 California

Profile Details

NPI number 1588086680
LBN Legal business name Gardner, Mary Katheryn
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2014
Last updated Jan 9th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588086680 NPPES
California Other 68677 RDA LICENSE

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