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Individual

ROSALYN MENDOZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDA

Contact information

Practice address
18264 RAMONA AVE, FONTANA, CA 92336-3060
(626) 536-2249
Mailing address
18264 RAMONA AVE, FONTANA, CA 92336-3060
(626) 536-2249

Taxonomy

Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
87846
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
87846
CA
Enumeration date
10/09/2020
Last updated
10/09/2020
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