Individual
LUIS TELLERIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDA
Contact information
Practice address
5162 E WHITTIER BLVD, LOS ANGELES, CA 90022
(323) 415-6161
(323) 416-0675
Mailing address
544 N BRITTANIA ST, LOS ANGELES, CA 90033
(323) 271-5629
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
45078
CA
Other
Enumeration date
01/14/2009
Last updated
01/14/2009
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