De Santiago, Leesette

De Santiago, Leesette is an individual health care provider with primary practice located at 6130 Camino Real #12 , Riverside CA 92509. She recently has only one registered license in Dental Providers / Dental Assistant, which is considered as her primary health care specialty. De Santiago, Leesette can be contacted via phone (951) 224-2253.

Contact Information

Primary practice address
6130 Camino Real #12 Riverside CA 92509
Phone: (951) 224-2253
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Assistant 126800000X 60639 California

Profile Details

NPI number 1720530744
LBN Legal business name De Santiago, Leesette
Credentials Registered Dental Assistant (RDA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2016
Last updated Oct 25th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720530744 NPPES
California MEDICAID 60639

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