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Individual

DR. CAMILLE M ORTEGA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
919 E MAIN ST, BARSTOW, CA 92311-2407
(760) 256-2425
Mailing address
4027 NOOK WAY APT D, LAS VEGAS, NV 89103-2550
(702) 499-3242

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
44973
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
D44973
CA
Enumeration date
05/29/2007
Last updated
07/09/2007
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