Individual
MISS BETTY SATOMI FUKUMOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
16008 S MANHATTAN PL, GARDENA, CA 90247-3681
(310) 650-4471
Mailing address
16008 S MANHATTAN PL, GARDENA, CA 90247-3681
(310) 650-4471
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
25039
CA
Other
Enumeration date
11/08/2020
Last updated
11/08/2020
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