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General NPI Number Information
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NPI Number | 1225519903
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Entity Type | Organization
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Legal Business Name | ARROW SMILE DENTAL A PRACTICE OF VICTOR M ROSALES DDS INC
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Dates
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Enumeration Date | 08/22/2018
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Last Update Date | 09/10/2019
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Provider Practice Location Address
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Address Line | 8363 RESEDA BLVD STE 202
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City | NORTHRIDGE
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State | CA
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Zip | 91324-5908
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Country | US
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Telephone | 818-405-0278
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Fax | 626-938-1238
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Provider Business Mailing Address
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Address Line | 20530 E ARROW HWY STE A
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City | COVINA
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State | CA
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Zip | 91724-1238
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Country | US
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Telephone | 626-938-1236
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VICTOR MAGPILI ROSALES
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Credential | DDS
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Telephone | 626-938-1236
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 55369
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License Number State | CA
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