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General NPI Number Information
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NPI Number | 1083837769
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Entity Type | Individual
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Provider Name | MARIA TERESA MANTUANO YEPIZ DENTIST
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Gender | Female
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1451 W ARTESIA BLVD SUITE 6
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City | GARDENA
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State | CA
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Zip | 90248-3232
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Country | US
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Telephone | 310-323-0290
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Fax |
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Provider Business Mailing Address
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Address Line | 9435 HEINER ST
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City | BELLFLOWER
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State | CA
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Zip | 90706-3059
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Country | US
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Telephone | 562-804-9091
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 41953
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License Number State | CA
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