Individual
MAYRA ACEVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11144 CARSON DR, LYNWOOD, CA 90262-2770
(562) 272-0000
Mailing address
11144 CARSON DR, LYNWOOD, CA 90262-2770
(562) 272-0000
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
4490699
CA
Other
Enumeration date
01/12/2009
Last updated
01/12/2009
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