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Individual

ERICA TOVAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDA

Contact information

Practice address
974 N MOUNTAIN AVE, ONTARIO, CA 91762-2113
(909) 984-0246
Mailing address
1339 N SULTANA AVE # B, ONTARIO, CA 91764-1811
(951) 286-7303
(909) 510-4556

Taxonomy

Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
71599
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
71599
CA
Enumeration date
04/06/2018
Last updated
04/06/2018
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