Mendoza, Baltazar
Mendoza, Baltazar is an sole proprietor health care provider with primary practice located at 7691 El Chaco Drive , Buena Park CA 90620. He recently has only one registered license in Dental Providers / Dental Assistant, which is considered as his primary health care specialty. Mendoza, Baltazar can be contacted via phone (562) 912-8307.Contact Information
Primary practice address
7691 El Chaco Drive
Buena Park CA 90620
Phone: (562) 912-8307
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dental Assistant | 126800000X | 68051 | California |
Profile Details
| NPI number | 1942531447 |
|---|---|
| LBN Legal business name | Mendoza, Baltazar |
| Credentials | Registered Dental Assistant (RDA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 22nd, 2010 |
| Last updated | Jan 22nd, 2010 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942531447 | NPPES |
| California | Other | 68051 | CALIFORNIA DENTAL BOARD |
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