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Individual

MARIA A PORTELA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
411 4TH ST, SAN RAFAEL, CA 94901-5716
(415) 488-1500
Mailing address
9 COMMERCIAL BLVD STE 100, NOVATO, CA 94949-6137
(415) 448-1500

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
35758
CA

Other

Enumeration date
04/24/2024
Last updated
04/24/2024
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