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Individual
MIRTHA MYREYA GOMEZ
Active
Individual
MIRTHA MYREYA GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
50407
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50407
LICENSE
CA
Enumeration date
01/10/2007
Last updated
10/19/2017
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