Individual
GRACE CAMPOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
1607 PENNSYLVANIA AVE, LOS ANGELES, CA 90033-2403
(323) 369-5453
Mailing address
1607 PENNSYLVANIA AVE, LOS ANGELES, CA 90033-2403
(323) 369-5453
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
15919
CA
Other
Enumeration date
01/20/2009
Last updated
01/20/2009
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