Individual
KAMRI DIANE CHAVEREST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
1725 W 6TH ST, LOS ANGELES, CA 90017-1000
(213) 413-5151
Mailing address
1765 E 108TH ST, LOS ANGELES, CA 90059-1203
(562) 208-7054
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
81938
CA
Other
Enumeration date
04/18/2017
Last updated
04/18/2017
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