Individual
MATTHEW SIRAGUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
792 SALINGER PL, SAN JACINTO, CA 92583
(951) 330-6166
Mailing address
792 SALINGER PL, SAN JACINTO, CA 92583-2052
(951) 330-6166
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
74736
CA
Other
Enumeration date
07/08/2016
Last updated
07/08/2016
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