Individual
KEVIN SANTOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
946 N WESTERN AVE, SAN PEDRO, CA 90732-2427
(310) 612-6182
Mailing address
742 W ALONDRA BLVD, GARDENA, CA 90247-4554
(310) 612-6182
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
35852
CA
Other
Enumeration date
09/11/2023
Last updated
09/11/2023
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