Individual
MARTIN MARCOS GUILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1025 W AVENUE K STE 105, LANCASTER, CA 93534-6429
(310) 409-9933
Mailing address
43243 33RD ST E, LANCASTER, CA 93535-4976
(661) 718-6016
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A66691
—
CA
Enumeration date
02/10/2021
Last updated
02/10/2021
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