Individual
JUAN JOSE GONZALEZ BONIFACIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5162 WHITTIER BLVD, LOS ANGELES, CA 90022-3932
(323) 510-5920
Mailing address
488 S BURLINGTON AVE, LOS ANGELES, CA 90057-3006
(213) 318-1079
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
RDA92496
CA
Other
Enumeration date
07/17/2019
Last updated
07/17/2019
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