Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | 71504 | CA |
NPI | 1144675935 |
---|---|
Provider Name | Eileen Sarto |
First Address | Norwalk, CA 90650-6941 |
Second Address | Long Beach, CA 90815-2850 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2016 |
Last Update Date | 28/04/2016 |