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General NPI Number Information
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NPI Number | 1023325701
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Entity Type | Organization
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Legal Business Name | DANIEL DORREGO DDS PA
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Dates
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Enumeration Date | 09/02/2010
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Last Update Date | 09/02/2010
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Provider Practice Location Address
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Address Line | 1075 E 4TH AVE
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City | HIALEAH
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State | FL
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Zip | 33010-4103
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Country | US
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Telephone | 305-558-3811
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Fax | 305-888-4324
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Provider Business Mailing Address
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Address Line | 1075 E 4TH AVE
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City | HIALEAH
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State | FL
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Zip | 33010-4103
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Country | US
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Telephone | 305-558-3811
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Fax | 305-888-4324
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANIEL ARTURO DORREGO
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Credential | D.D.S
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Telephone | 305-558-3811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0012625
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License Number State | FL
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