Individual
MIREYA DEE SANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.A
Contact information
Practice address
10721 TELECHRON AVE APT 9, WHITTIER, CA 90605-3421
(562) 278-4950
Mailing address
10721 TELECHRON AVE APT 9, WHITTIER, CA 90605-3421
(562) 278-4950
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
72529
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
72529
—
CA
Enumeration date
03/20/2017
Last updated
03/20/2017
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