Individual
SARA GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
4000 LA RICA AVE STE D, BALDWIN PARK, CA 91706-3163
(626) 430-9171
Mailing address
334 BALHAM AVE, LA PUENTE, CA 91744-6109
(626) 581-0708
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
59939
CA
Other
Enumeration date
01/09/2009
Last updated
01/09/2009
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