Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | 77545 | CA |
NPI | 1295119568 |
---|---|
Provider Name | Saima Martinez |
First Address | Bellflower, CA 90706-6653 |
Second Address | Bellflower, CA 90706 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2015 |
Last Update Date | 16/07/2015 |