Individual
AMANDA JACOVANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2878 CAMPUS PKWY STE 1, RIVERSIDE, CA 92507-0945
(951) 571-0011
Mailing address
464 SONORA CIR, REDLANDS, CA 92373-8510
(951) 236-0252
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
106923
CA
Other
Enumeration date
09/01/2021
Last updated
09/01/2021
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