Individual
REYDESEL TENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DA, X-RAY LICENSED
Contact information
Practice address
44558 10TH ST W, LANCASTER, CA 93534-3333
(661) 723-1111
Mailing address
1368 E AVENUE R2, PALMDALE, CA 93550-5342
(661) 433-3956
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
03/12/2011
Last updated
03/12/2011
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