Individual provider · NPI-1

Nellie M Acevedo, RDA

Dental Assistant · Lynwood, CA

NPI number1659718484
StatusActive
Last updated in NPPESJun 3, 2013

Details

NPI
1659718484
Entity type
Individual (NPI-1)
Name
Ms. Nellie M Acevedo
Credential
RDA
Sex
Female
Sole proprietor
Yes
Enumeration date
Jun 3, 2013
Last updated
Jun 3, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
126800000X Dental Assistant56812CAYes

Practice location

9910 Long Beach Blvd Ste A
Lynwood, CA 90262-1561

Phone 323-563-8900

Mailing address

1121 E Tucker St
Compton, CA 90221-1282

Phone 323-246-3894

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