Individual
MRS. MARY JANE DE LEON SALAPONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
2440 RIVER RD STE 140, NORCO, CA 92860-2402
(888) 904-3204
Mailing address
34094 LADY FERN CT, LAKE ELSINORE, CA 92532-2940
(949) 483-0369
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
RDA58343
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RDA58343
—
CA
Enumeration date
04/27/2018
Last updated
04/27/2018
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