Individual
REYNALDO RAYMUNDO PENOLIAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1530 BERKSHIRE DR, PALMDALE, CA 93551-4052
(818) 284-0847
Mailing address
1530 BERKSHIRE DR, PALMDALE, CA 93551-4052
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
72915
CA
Other
Enumeration date
08/12/2020
Last updated
08/12/2020
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