Individual
JESUS ANTONIO SAMANIEGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13235 BARLIN AVE, DOWNEY, CA 90242-5103
(562) 970-8612
Mailing address
13235 BARLIN AVE, DOWNEY, CA 90242-5103
(562) 970-8612
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
4490492
CA
Other
Enumeration date
01/12/2009
Last updated
01/12/2009
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