Individual
MR. ANDREW CARRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RDA
Contact information
Practice address
1205 RENAISSANCE PKWY STE 240, RIALTO, CA 92376-2418
(909) 243-7939
Mailing address
1205 RENAISSANCE PKWY STE 240, RIALTO, CA 92376-2418
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
RDA89721
CA
Other
Enumeration date
01/29/2019
Last updated
01/29/2019
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