Individual
DR. CARLOS MAURICIO HENAO ORTEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
25044 PEACHLAND AVENUE SUITE 100, LOS ANGELES, CA 90089-5746
(661) 287-4352
Mailing address
24515 ROSETTE LN, VALENCIA, CA 91354-3036
(314) 315-6999
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
109335
CA
Other
Enumeration date
07/13/2023
Last updated
04/08/2024
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