Individual
MRS. VIDA ALIP CABALLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
313 E MAPLE ST APT A, GLENDALE, CA 91205-2195
(818) 549-0871
Mailing address
313 E MAPLE ST APT A, GLENDALE, CA 91205-2195
(818) 549-0871
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
36932
CA
Other
Enumeration date
01/21/2009
Last updated
01/21/2009
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