Individual
MRS. AIDA LIZETH WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
732 MOTT ST STE 110, SAN FERNANDO, CA 91340-4240
(818) 963-5690
Mailing address
732 MOTT ST STE 110, SAN FERNANDO, CA 91340-4240
(818) 963-5690
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
27831
CA
Other
Enumeration date
07/29/2021
Last updated
07/30/2021
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