Individual
ERICA AVILA CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1014 BROADMOOR AVE, LA PUENTE, CA 91744-1806
(661) 427-1943
Mailing address
1014 BROADMOOR AVE, LA PUENTE, CA 91744-1806
(661) 427-1943
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
73796
CA
Other
Enumeration date
02/03/2014
Last updated
02/03/2014
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