Individual
MELLISA GARCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24350 GABRIEL ST, MORENO VALLEY, CA 92551-3639
(951) 867-1348
Mailing address
24350 GABRIEL ST, MORENO VALLEY, CA 92551-3639
(951) 867-1348
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
93699
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
93699
—
CA
Enumeration date
11/21/2020
Last updated
11/21/2020
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