Individual
MRS. FEBELYN GACES BALLUNGAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21229 HAWTHORNE BLVD STE A, TORRANCE, CA 90503-5501
(310) 792-5600
(310) 792-5628
Mailing address
2066 CASPIAN AVE, LONG BEACH, CA 90810-4163
(310) 792-5600
(310) 792-5628
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
65117
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
65117
RDA LICENSE
CA
Enumeration date
01/20/2009
Last updated
01/20/2009
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