Individual
GRICELDA PERALTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.H, R.D.H.A.P.
Contact information
Practice address
322 CULVER BLVD, SUITE 187, PLAYA DEL REY, CA 90293-7704
(310) 779-9712
Mailing address
322 CULVER BLVD, SUITE 187, PLAYA DEL REY, CA 90293-7704
(310) 779-9712
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
18576
CA
124Q00000X
Dental Hygienist
Primary
296
CA
Other
Enumeration date
06/22/2010
Last updated
06/22/2010
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