Individual
GUILLERMINA VIVEROS ROSAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1205 RENAISSANCE PKWY UNIT 420, RIALTO, CA 92376-2417
(909) 543-0317
Mailing address
9262 BEGONIA AVE, HESPERIA, CA 92344-4615
(951) 892-9646
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
32454
CA
Other
Enumeration date
12/21/2018
Last updated
12/21/2018
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