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General NPI Number Information
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NPI Number | 1336303296
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Entity Type | Individual
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Provider Name | DAVID MICHAEL DUGGAN D.D.S., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 1076 SANTO ANTONIO DR SUITE K
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City | COLTON
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State | CA
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Zip | 92324-8103
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Country | US
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Telephone | 909-824-7179
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Fax | 909-824-2730
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Provider Business Mailing Address
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Address Line | 1076 SANTO ANTONIO DR SUITE K
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City | COLTON
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State | CA
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Zip | 92324-8103
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Country | US
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Telephone | 909-824-7179
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Fax | 909-824-2730
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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 | 40074
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License Number State | CA
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