Individual
DENISSE LARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1525 BORDER AVE APT D, CORONA, CA 92882-7018
(949) 247-1128
Mailing address
1525 BORDER AVE APT D1525, CORONA, CA 92882-7004
(949) 247-1128
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
03/30/2021
Last updated
03/30/2021
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