Individual
ALIVIA JANE STODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
14101 NELSON AVE, LA PUENTE, CA 91746-2640
(425) 318-2081
Mailing address
12132 CONCORD CT, CHINO, CA 91710-2161
(425) 318-2081
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
106821
CA
Other
Enumeration date
08/31/2021
Last updated
08/31/2021
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