Individual
JILL PAULINE CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
763 RIO RANCHO RD, POMONA, CA 91766-7015
(909) 242-7989
Mailing address
763 RIO RANCHO RD, POMONA, CA 91766-7015
(909) 242-7989
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
07/14/2017
Last updated
07/21/2022
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