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General NPI Number Information
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NPI Number | 1932595022
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Entity Type | Individual
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Provider Name | TANYA MURIEL CASTRO
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Gender | Female
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Dates
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Enumeration Date | 04/15/2015
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Last Update Date | 04/15/2015
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Provider Practice Location Address
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Address Line | 37945 30TH ST E APT 206
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City | PALMDALE
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State | CA
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Zip | 93550-5533
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Country | US
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Telephone | 661-874-3003
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Fax |
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Provider Business Mailing Address
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Address Line | 37945 30TH ST E APT 206
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City | PALMDALE
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State | CA
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Zip | 93550-5533
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Country | US
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Telephone | 661-874-3003
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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 | 126800000X
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Taxonomy Name | Dental Assistant
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License Number | 67307
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License Number State | CA
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