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General NPI Number Information
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NPI Number | 1538076815
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Entity Type | Individual
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Provider Name | CAROLINA GUADALUPE MARTIN RDH
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Gender | Female
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Dates
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Enumeration Date | 08/25/2026
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Last Update Date | 08/25/2026
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Provider Practice Location Address
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Address Line | 1163 W GRAND AVE
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City | GROVER BEACH
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State | CA
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Zip | 93433-2149
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Country | US
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Telephone | 805-904-6979
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Fax |
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Provider Business Mailing Address
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Address Line | 247 OLIVOS LN
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City | NIPOMO
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State | CA
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Zip | 93444-9543
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Country | US
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Telephone | 661-480-3295
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 32225
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License Number State | CA
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