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JOHN R DAGOSTINO DDS

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1407912181

Individual Registrant:
 JOHN R DAGOSTINO DDS
Gender: M
Not Sole Proprietor

Location and contact information for practice:
15925 EAST GALE AVE SUITE C HACIENDA HIEGHTS, CA 91745 US
Tel: 626-336-6401  Fax: 626-336-5394

Contact information for business:
15925 EAST GALE AVE SUITE C HACIENDA HIEGHTS, CA 91745 US
Tel: 626-336-6401  Fax: 626-336-5394

Registration Information:
NPI: 1407912181
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
CA30427

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
MEDICAL #B3042701CA01




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