Individual
MYA LATRICE HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4TH AND INNER LOOP ROAD, BLDG 171, FORT IRWIN, CA 92310
(719) 526-5537
Mailing address
4TH AND INNER LOOP ROAD, BLDG 171, FORT IRWIN, CA 92310
(719) 526-5537
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
05/15/2020
Last updated
05/15/2020
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