Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | 38563 | CA |
NPI | 1306213806 |
---|---|
Provider Name | Mrs. Maria Cecilia Royo |
First Address | Lancaster, CA 93536-1822 |
Second Address | Lancaster, CA 93534-3333 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2015 |
Last Update Date | 31/08/2015 |