Individual
MR. CARLOS HERIBERTO QUINONEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RDHAP, BS
Contact information
Practice address
16077 CHELLA DR, HACIENDA HEIGHTS, CA 91745-6402
(323) 447-5480
Mailing address
16077 CHELLA DR, HACIENDA HEIGHTS, CA 91745-6402
(323) 447-5480
Taxonomy
Speciality
Code
Description
License number
State
125K00000X
Advanced Practice Dental Therapist
Primary
742
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
742
DENTAL HYGIENE BOARD OF CALIFORNIA
CA
Enumeration date
11/06/2020
Last updated
11/06/2020
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