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DR. SUSAN TUNQUE DE MATA D.D.S.

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1922289982

Individual Registrant:
DR. SUSAN TUNQUE DE MATA D.D.S.
Gender: F
Sole Proprietor

Location and contact information for practice:
18516 DEVLIN AVE  ARTESIA, CA 90701-5730 US
Tel: 562-860-6421  Fax: 562-424-9848

Contact information for business:
18516 DEVLIN AVE  ARTESIA, CA 90701-5730 US
Tel: 562-860-6421  Fax: 562-424-9848

Registration Information:
NPI: 1922289982
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
CA56582

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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