MS. Erica Berenice Licea, RDA ORTHO ASSISTANT
NPI #1376002287 in Rialto, California
Provider Information
- NPI Number
- 1376002287
- Entity Type
- Individual
- Name
- MS. Erica Berenice Licea, RDA ORTHO ASSISTANT
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dental Assistant
- Credential
- RDA ORTHO ASSISTANT
- Enumeration Date
- Mar 19, 2019
- Last Updated
- Mar 19, 2019
Practice Location
- Address
- 1342 W LA GLORIA DR
- City
- Rialto
- State
- California
- ZIP Code
- 92377-4466
- Phone
- (951) 465-9162
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dental Assistant |
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