Individual
MISS TARA LEE M LACHICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDHAP
Contact information
Practice address
12654 NOTTINGHAM DR, RANCHO CUCAMONGA, CA 91739-9168
(909) 525-2375
Mailing address
15413 ELM LN, CHINO HILLS, CA 91709-2929
(909) 525-2375
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
RDHAP 398
CA
Other
Enumeration date
09/02/2012
Last updated
09/02/2012
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