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DR. ANTONIO FANDINO AGRA DMD

>> Dentist >> Dental Providers

Registrant 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:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
CA25664

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
MEDICAL501908CA01




HEALTH CARE JOBS CA - Page 1



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