Healthcare Provider Details

I. General information

NPI: 1326826140
Provider Name (Legal Business Name): ALDO FLORES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2023
Last Update Date: 09/21/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MISION SANTO DOMINGO #1052 INT 5
TECATE BAJA CALIFORNIA
21478
MX

IV. Provider business mailing address

2382 ANGELA ST APT B
POMONA CA
91766-5959
US

V. Phone/Fax

Practice location:
  • Phone: 619-272-9021
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ALDO FLORES
Title or Position: DENTIST
Credential: DDS
Phone: 619-272-9021