Individual
MRS. ILIANA DURAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11334 SSG SIMS RD, FT. BLISS, TX 79908
(915) 742-6083
Mailing address
5372 JOSE DURAN LN, EL PASO, TX 79934-3184
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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