Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | 75116 | CA |
NPI | 1114394970 |
---|---|
Provider Name | Linda Rocio Galdamez |
First Address | Riverside, CA 92505-2340 |
Second Address | Riverside, CA 92505-2340 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2015 |
Last Update Date | 27/08/2015 |