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1942531447
BALTAZAR MENDOZA
BUENA PARK, CA
NPI
1942531447
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
126800000X Dental Assistant
(Licence: CA 68051)
Enumeration Date
2010-01-22
Last Update Date
2010-01-22
Business Address
BALTAZAR MENDOZA R.D.A
7691 EL CHACO DRIVE
BUENA PARK, CA 90620
Phone number: 562-912-8307
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Mailing Address
BALTAZAR MENDOZA R.D.A
7691 EL CHACO DR
BUENA PARK, CA 90620-1807
Phone number: 562-912-8307
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