Individual
IRVING AVALOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1160 E ONTARIO AVE, CORONA, CA 92881-8653
(951) 531-9504
Mailing address
2085 PORTER ST, SAN BERNARDINO, CA 92407-6540
(909) 600-4870
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
RDA86861
CA
Other
Enumeration date
03/06/2018
Last updated
03/06/2018
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