Individual
EKATERINA A FEDOSEEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7011 LINDA VISTA RD, SAN DIEGO, CA 92111-6307
(858) 810-8729
Mailing address
7011 LINDA VISTA RD, SAN DIEGO, CA 92111-6307
(858) 810-8729
(858) 987-5823
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Enumeration date
11/13/2019
Last updated
11/13/2019
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