Individual
CARLA VANESSA CEBALLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1336 W VALENCIA DR APT A, FULLERTON, CA 92833-4043
(914) 268-1016
Mailing address
1336 W VALENCIA DR APT A, FULLERTON, CA 92833-4043
(914) 268-1016
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
107223
CA
Other
Enumeration date
01/03/2022
Last updated
01/06/2022
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