Individual
AMAIRAINY ACEVEDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
179 N TUSTIN ST, ORANGE, CA 92867-7716
(714) 288-1035
Mailing address
1210 S LINDA WAY, SANTA ANA, CA 92704-3311
(951) 210-8682
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
78734
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78734
—
CA
Enumeration date
02/17/2020
Last updated
02/17/2020
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