Individual
MARIA JAIMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDAEF2
Contact information
Practice address
79800 HIGHWAY 111 STE 109, LA QUINTA, CA 92253-6003
(951) 250-8121
Mailing address
13390 LARKHAVEN DR, MORENO VALLEY, CA 92553-3205
(951) 250-8121
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
AEF1330
CA
126800000X
Dental Assistant
RDA62866
CA
Other
Enumeration date
05/16/2024
Last updated
05/16/2024
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