Healthcare Provider Details

I. General information

NPI: 1922644293
Provider Name (Legal Business Name): FABRIZIO DALL'OLMO DDS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2019
Last Update Date: 12/12/2019
Certification Date: 12/12/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7721 PAINTER AVE
WHITTIER CA
90602-2411
US

IV. Provider business mailing address

7721 PAINTER AVE
WHITTIER CA
90602-2411
US

V. Phone/Fax

Practice location:
  • Phone: 562-309-4433
  • Fax: 562-309-4433
Mailing address:
  • Phone: 562-309-4433
  • Fax: 562-309-4433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. FABRIZIO DALL'OLMO
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 562-309-4433