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Individual

EMMANUEL GABRIEL SOLANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1705 S 4TH ST APT C, ALHAMBRA, CA 91803-3522
(323) 596-5481
Mailing address
1705 S 4TH ST APT C, ALHAMBRA, CA 91803-3522
(323) 596-5481

Taxonomy

Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
66928
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
66928
CA
Enumeration date
09/19/2018
Last updated
09/19/2018
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