Individual
DR. AMITA RASTOGI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1284 E LATHAM AVE, HEMET, CA 92543-4445
(951) 306-2869
Mailing address
1275 E LATHAM AVE, HEMET, CA 92543-4424
(951) 306-2869
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
019027846
IL
1223P0300X
Periodontics
Primary
56790
CA
Other
Enumeration date
09/04/2009
Last updated
04/25/2012
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