Individual
ROSA MORALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15350 NORDHOFF ST STE A, NORTH HILLS, CA 91343-2234
(818) 672-8228
Mailing address
6918 JORDAN AVE, CANOGA PARK, CA 91303-1904
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
45115
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45115
RDA LICENSE
—
Enumeration date
10/07/2010
Last updated
10/07/2010
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