Individual
GRETA MACIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6713 SOUTH CHESTNUT AVE., FRESNO, CA 93725
(559) 325-6161
Mailing address
6713 SOUTH CHESTNUT AVE., FRESNO, CA 93725
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
5597972774
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5597972774
DENTAL ASSISTANT
—
Enumeration date
02/02/2010
Last updated
02/02/2010
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