NPI Search for Physicians and Health Care Providers
DR. ANTONIO FANDINO AGRA DMD
>> Dentist >> Dental ProvidersRegistrant NPI Number: 1033277215
Individual Registrant:
DR. ANTONIO FANDINO AGRA DMD
Gender: M
Not Sole Proprietor
Location and contact information for practice:
17613 PIONEER BLVD ARTESIA, CA 90701 US
Tel: 562-809-8482 Fax: 562-402-4012
Contact information for business:
17613 PIONEER BLVD ARTESIA, CA 90701 US
Tel: 562-809-8482 Fax: 562-402-4012
Registration Information:
NPI: 1033277215
Entity Type: Individual
Specialty information:
Primary | Code | Category/Description | State | License Number |
---|
Y | 122300000X | Dental Providers Dentist
| CA | 25664 |
Legacy codes, insurance codes and state license numbers:
Issuer | Number | State | Type |
---|
MEDICAL | 501908 | CA | 01 |
HEALTH CARE JOBS CA - Page 1