Individual
ANDREA CONNERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
13218 AVALON BLVD APT 219, LOS ANGELES, CA 90061-2363
(424) 394-7579
Mailing address
13218 AVALON BLVD APT 219, LOS ANGELES, CA 90061-2363
(424) 394-7579
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
81182
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81182
—
CA
Enumeration date
10/06/2020
Last updated
10/06/2020
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