Individual
JESSICA PHAN MACHADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3991 GRAND AVE STE D, CHINO, CA 91710-5442
(909) 591-0077
Mailing address
16008 LEGACY RD UNIT 307, TUSTIN, CA 92782-2812
(949) 392-2827
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
65300
CA
Other
Enumeration date
09/05/2017
Last updated
09/05/2017
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