Individual
ANTHONY URREA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1227 E PUENTE AVE, WEST COVINA, CA 91790-1359
(626) 644-8793
Mailing address
1227 E PUENTE AVE, WEST COVINA, CA 91790-1359
(626) 644-8793
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
82517
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RDA82517
—
CA
Enumeration date
12/30/2020
Last updated
12/30/2020
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