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Individual

MR. GUSTAVO ANTONIO VARGAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RDA

Contact information

Practice address
11054 PASO ROBLES AVE, GRANADA HILLS, CA 91344
(818) 470-9203
Mailing address
11054 PASO ROBLES AVE, GRANADA HILLS, CA 91344-4934
(818) 470-9203

Taxonomy

Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
63428
CA

Other

Enumeration date
06/18/2009
Last updated
06/18/2009
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