Individual
JONATHAN PASCUAL ROSALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6952 SIERRA HWY, AGUA DULCE, CA 91390-4598
(818) 483-3701
Mailing address
6952 SIERRA HWY, AGUA DULCE, CA 91390-4598
(818) 483-3701
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
RDA96158
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RDA96158
—
CA
Enumeration date
04/08/2021
Last updated
04/08/2021
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