Individual
CLARISSA CERVANTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
208 E CARSON ST STE 200, CARSON, CA 90745-2763
(310) 830-2624
Mailing address
208 E CARSON ST STE 200, CARSON, CA 90745-2763
(310) 830-2624
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
109304
CA
Other
Enumeration date
09/07/2023
Last updated
09/07/2023
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