Individual
MS. MARIA G AVILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
4126 ROGERS ST, LOS ANGELES, CA 90063-1154
(323) 691-3894
Mailing address
4126 ROGERS ST, LOS ANGELES, CA 90063-1154
(323) 691-3894
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
64284
CA
Other
Enumeration date
05/12/2015
Last updated
05/12/2015
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