NPI 1063034734

Gina Costa, RDA

Practitioner Dental Assistant Pomona, CA

Practice location

Address: 763 Rio Rancho Rd, Pomona, CA 91766-7015
Phone: (949) 338-6424
Mailing address: PO Box 9083, Anaheim, CA 92812-7083

Registered specialties

Dental Assistant Primary

Dental Providers Taxonomy 126800000X Licence 44849 (CA)

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Registry record

NPI: 1063034734
Entity type: Individual
Sex (as registered): Female
NPI issued: 15 May 2020
Record last updated: 15 May 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.