Individual
SANDRA MICHELLE HENRIQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDHAP
Contact information
Practice address
3163 IVY ST, LOS ANGELES, CA 90034-3212
(310) 694-7421
(310) 839-7367
Mailing address
3163 IVY ST, LOS ANGELES, CA 90034-3212
(310) 694-7421
(310) 839-7367
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
698
CA
Other
Enumeration date
06/18/2018
Last updated
06/18/2018
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