Individual
BLANCA ERICA MACIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
661 W 1ST ST STE G, TUSTIN, CA 92780-2939
(714) 665-9890
(714) 665-9891
Mailing address
661 W 1ST ST STE G, TUSTIN, CA 92780-2939
(714) 665-9890
(714) 665-9891
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
28996
CA
Other
Enumeration date
06/16/2023
Last updated
06/16/2023
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