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General NPI Number Information
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NPI Number | 1063635241
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Entity Type | Individual
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Provider Name | ENRIQUE FLORES D.D.S
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Gender | Male
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 15431 AMAR RD
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City | LA PUENTE
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State | CA
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Zip | 91744-2803
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Country | US
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Telephone | 626-968-5110
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Fax |
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Provider Business Mailing Address
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Address Line | 721 HAY ST
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City | MONTEBELLO
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State | CA
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Zip | 90640-2336
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Country | US
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Telephone | 323-273-4773
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 47368
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License Number State | CA
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