Individual
JULIO MADRID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RDA
Contact information
Practice address
16205 SEVILLE AVE, FONTANA, CA 92335-3383
(909) 997-3373
Mailing address
16205 SEVILLE AVE, FONTANA, CA 92335-3383
(909) 997-3373
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
04/21/2015
Last updated
04/21/2015
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