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General NPI Number Information
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NPI Number | 1427291277
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Entity Type | Individual
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Provider Name | DEMETRIO LABSO DOMINGO D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 04/09/2009
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Last Update Date | 04/09/2009
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Provider Practice Location Address
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Address Line | 1701 16TH ST NW 217
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City | WASHINGTON
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State | DC
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Zip | 20009-3145
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Country | US
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Telephone | 202-714-8727
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Fax |
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Provider Business Mailing Address
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Address Line | 1701 16TH ST NW 217
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City | WASHINGTON
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State | DC
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Zip | 20009-3145
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Country | US
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Telephone | 301-402-1706
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Fax | 301-480-4455
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 41827
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DEN1000553
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 051929-1
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License Number State | NY
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