Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | 63852 | CA |
NPI | 1295969368 |
---|---|
Provider Name | Mariza Rubi Salazar |
First Address | San Luis Rey, CA 92068-0606 |
Second Address | Oceanside, CA 92057 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2009 |
Last Update Date | 05/05/2009 |