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NPI Code Detail

MEDICARE: RODERICK PANGILINAN DENTAL CORPORATION

MEDICARE: RODERICK PANGILINAN DENTAL CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1922861400
Entity Type Code : Organization
Provider Name (Legal Business Name) : RODERICK PANGILINAN DENTAL CORPORATION
Provider Business Mailing Address
First Line : 1098 SKYVIEW AVE
Second Line :
City : EL CENTRO
State : CA
Zip : 92243-9133
Country : US
Telephone Number : 619-677-0598
Fax Number :
Provider Business Practice Location Address
First Line : 301 N IMPERIAL AVE STE F
Second Line :
City : EL CENTRO
State : CA
Zip : 92243-2338
Country : US
Telephone Number : 760-353-1059
Fax Number : 760-353-7378
Authorized Official
Title or Position : D.D.S./OWNER
Name : RODERICK PANGILINAN
Credential :
Telephone Number : 619-677-0598
Provider Enumeration Date : 02/06/2024
Last Update Date : 02/06/2024

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Directions to “RODERICK PANGILINAN DENTAL CORPORATION ” Practice Location

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