Individual
ABIGAIL ALYSSA AVILES MANAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24021 ALESSANDRO BLVD STE A120, MORENO VALLEY, CA 92553-6710
(951) 242-3328
(951) 924-1134
Mailing address
11160 RICHIE CIRCLE APT B, LOMA LINDA, CA 92354-2951
(909) 569-4572
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DDS106983
CA
Other
Enumeration date
12/07/2021
Last updated
12/07/2021
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