Individual
LARISA BREANA WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13808 CERISE AVE APT 14, HAWTHORNE, CA 90250-8722
(310) 469-8181
Mailing address
13808 CERISE AVE APT 14, HAWTHORNE, CA 90250-8722
(310) 469-8181
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
RDA89125
CA
Other
Enumeration date
02/25/2019
Last updated
02/25/2019
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