Individual
MRS. PRIMER IGNACIO BAYANI USITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDA
Contact information
Practice address
11635 E. SOUTH STREET, ARTESIA, CA 90701
Mailing address
11635 SOUTH ST, ARTESIA, CA 90701-6628
(562) 924-4401
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
63792
CA
Other
Enumeration date
12/17/2018
Last updated
12/17/2018
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