Individual
MRS. MARY JADE GUECO SANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
24565 TOWN CENTER DR APT 8418, VALENCIA, CA 91355-0822
(818) 415-0910
Mailing address
24565 TOWN CENTER DR APT 8418, VALENCIA, CA 91355-0822
(818) 415-0910
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
RDA46008
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RDA46008
—
CA
Enumeration date
09/10/2019
Last updated
09/10/2019
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