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General NPI Number Information
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NPI Number | 1376903054
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Entity Type | Organization
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Legal Business Name | MILAGROS J. MACARAIG DDS INC
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Dates
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Enumeration Date | 02/24/2016
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Last Update Date | 05/26/2016
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Provider Practice Location Address
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Address Line | 15228 HAWTHORNE BLVD SUITE A
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City | LAWNDALE
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State | CA
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Zip | 90260-2138
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Country | US
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Telephone | 310-679-8000
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Fax | 310-644-3992
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Provider Business Mailing Address
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Address Line | 15228 HAWTHORNE BLVD SUITE A
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City | LAWNDALE
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State | CA
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Zip | 90260-2138
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Country | US
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Telephone | 310-679-8000
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Fax | 310-644-3992
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Authorized Official
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Title or Position | OWNER
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Name | MILAGROS JAVIER MACARAIG
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Credential | DDS
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Telephone | 310-679-8000
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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 |
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License Number State |
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