Individual
JAMIE LEAH TELLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
3027 W FLORIDA AVE, HEMET, CA 92545-3617
(951) 791-9111
Mailing address
3027 FLORIDA AVE, HEMET, CA 92545
(951) 791-9111
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
RDA81056
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RDA81056
DENTAL BOARD OF CALIFORNIA
CA
Enumeration date
09/13/2017
Last updated
09/13/2017
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