Individual
MRS. TATIANA BOJORQUEZ GRIJALVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
808 LARIMORE AVE, LA PUENTE, CA 91744-3028
(626) 261-6630
Mailing address
808 LARIMORE AVE, LA PUENTE, CA 91744-3028
(626) 261-6630
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
83071
CA
Other
Enumeration date
06/24/2015
Last updated
06/24/2015
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