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General NPI Number Information
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NPI Number | 1386744290
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Entity Type | Individual
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Provider Name | AMADIS J. LUGO-DENTON DDS
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Gender | Male
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 283 MAIN ST STE 102
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City | BRAWLEY
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State | CA
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Zip | 92227-2350
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Country | US
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Telephone | 760-344-3583
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Fax | 760-344-8480
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Provider Business Mailing Address
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Address Line | 283 MAIN ST STE 102
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City | BRAWLEY
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State | CA
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Zip | 92227-2350
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Country | US
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Telephone | 760-344-3583
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Fax | 760-344-8480
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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 | 40268
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License Number State | CA
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