Individual
PROF. MARIAH BONNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH, MSDH
Contact information
Practice address
4415 S CENTRAL AVE, LOS ANGELES, CA 90011-3629
(323) 908-4200
Mailing address
3656 SUNSET RIDGE RD, ALTADENA, CA 91001-3863
(626) 695-0510
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
19729
CA
Other
Enumeration date
06/19/2025
Last updated
06/19/2025
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