| NPI | 1033911623 |
|---|---|
| Former Legal Business Name | VANESSA DE JESUS MENDIVIL CAMACHO |
| Entity Type | Organization |
| Authorized Contact | VANESSA DE JESUS MENDIVIL CAMACHO Dentist 562-352-0417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2025-03-25 |
| Last Update Date | 2025-03-25 |