Individual
NICOLE GRACELLA ARREDONDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
1633 S ALAMEDA ST # A, RANCHO DOMINGUEZ, CA 90220-4976
(310) 627-6500
Mailing address
2601 E VICTORIA ST SPC 412, RANCHO DOMINGUEZ, CA 90220-6823
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
RDA86440
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RDA86440
—
CA
Enumeration date
07/06/2020
Last updated
07/06/2020
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