Individual
DR. CARRIE AKEMI IMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MS
Contact information
Practice address
3511 MADISON ST, RIVERSIDE, CA 92504-3739
(310) 801-8010
Mailing address
18740 VIKINGS WAY, CERRITOS, CA 90703-6169
(310) 801-8010
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
53912
CA
Other
Enumeration date
10/14/2008
Last updated
10/14/2008
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