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Individual

SAYRA MARIA ANTOLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
11635 SOUTH ST, ARTESIA, CA 90701-6628
(562) 924-4401
Mailing address
1303 VIA SANTIAGO UNIT C, CORONA, CA 92882-3828
(714) 395-3451

Taxonomy

Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
93134
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
93134
CA
Enumeration date
09/23/2020
Last updated
09/23/2020
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