Natalie Kristine Provenzano
ActiveCalifornia license 49869
License
- Licensed by
- Dental Board of California
- License number
- 49869
- Status
- Active (Current)
- First issued
- August 20, 2002
- Expires
- September 30, 2028
- License holder
- Natalie Kristine Provenzano
- Entity type
- Individual
Classifications
- Dental License Dental
More from the license record
- License type code
- 4401
Contact
6020 Hellyer Ave., Suite 100
San Jose, CA 95138
San Jose, CA 95138
Santa Clara County