Individual
KIMBERLY MARIE TALLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9745 LAUREL CANYON, PACOIMA, CA 91331
(213) 248-0532
Mailing address
13909 PINNEY ST, PACOIMA, CA 91331-3624
(213) 248-0532
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
89660
—
Other
Enumeration date
08/05/2020
Last updated
08/05/2020
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