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Individual

MRS. JUANITA CORTES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDA

Contact information

Practice address
12121 WILSHIRE BLVD, LOS ANGELES, CA 90025-1123
(310) 525-0172
Mailing address
25285 PINE CREEK LN, WILMINGTON, CA 90744-1863
(310) 525-0172

Taxonomy

Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
62270
CA

Other

Enumeration date
06/01/2015
Last updated
06/01/2015
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