Individual
MARY CRUZ AGUILAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DENTAL HYGIENIST
Contact information
Practice address
1901 W WESTERN AVE STE B, SOUTH BEND, IN 46619-3570
(574) 234-9033
Mailing address
1901B W WESTERN AVE # B, SOUTH BEND, IN 46619-3521
(574) 234-9033
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
13007812A
IN
Other
Enumeration date
08/31/2020
Last updated
08/31/2020
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