Individual
JEANNETTE LISA AVILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDHAP
Contact information
Practice address
11198 TERRA VISTA PKWY APT 112, RANCHO CUCAMONGA, CA 91730-7422
(909) 279-8558
Mailing address
11198 TERRA VISTA PKWY APT 112, RANCHO CUCAMONGA, CA 91730-7422
(909) 279-8558
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
21920
CA
Other
Enumeration date
05/10/2018
Last updated
05/10/2018
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