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Individual

MS. ETHEL CORTEZ MIJARES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DENTAL ASSISTANT

Contact information

Practice address
BLDG 171, 4TH & INNER LOOP ROAD, FORT IRWIN, CA 92310
(719) 526-5537
Mailing address
BLDG 171, 4TH & INNER LOOP ROAD, FORT IRWIN, CA 92310

Taxonomy

Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary

Other

Enumeration date
11/09/2017
Last updated
11/09/2017
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