Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | 90655 | CA |
NPI | 1194390708 |
---|---|
Provider Name | Erika Aguilar |
First Address | Buena Park, CA 90621-2377 |
Second Address | Rosemead, CA 91770-4394 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2021 |
Last Update Date | 25/05/2021 |