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Individual
JOSE MENDOZA
Active
Individual
JOSE MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE60772766
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE60772766
DEPT. OF HEALTH. WASHINGTON STATE
WA
Enumeration date
05/25/2017
Last updated
07/26/2023
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