| NPI | 1124416425 |
|---|---|
| Other Name | BRENDA CASILLAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 111248) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CA 449) |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2025-09-04 |