Individual
PROF. BLANCA ESPARZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
213 W G ST, ONTARIO, CA 91762-3227
(909) 986-6180
(909) 986-6179
Mailing address
527 N PALM AVE, ONTARIO, CA 91762-3215
(909) 984-3618
(909) 984-9479
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
41648
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10442-1
BLUE SHIELD
CA
01
—
786491
UNITED CONCORDIA
CA
05
—
B41848-01
—
CA
Enumeration date
02/08/2006
Last updated
10/18/2018
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