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Individual

JOAHN SANDOVAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
28610 CALLE DEL LAGO APT C, MURRIETA, CA 92563-6052
(951) 296-8817
Mailing address
28610 CALLE DEL LAGO APT C, MURRIETA, CA 92563-6052

Taxonomy

Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
68988
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
68988
DENTAL ASSISTANT
CA
Enumeration date
06/27/2018
Last updated
06/27/2018
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