Individual
MAYRA RAQUEL REYNOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1406 N AZUSA AVE, COVINA, CA 91722-1257
(626) 858-9940
Mailing address
1935 E GARVEY AVE N APT 5, WEST COVINA, CA 91791-1456
(760) 222-8644
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
01/22/2009
Last updated
01/22/2009
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