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General NPI Number Information
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NPI Number | 1457611469
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Entity Type | Organization
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Legal Business Name | HECTOR Z. LANDIG, D.M.D., INC.
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Dates
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Enumeration Date | 05/23/2012
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Last Update Date | 06/29/2021
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Provider Practice Location Address
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Address Line | 1241 GRAND AVE SUITE G
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City | DIAMOND BAR
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State | CA
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Zip | 91765-4447
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Country | US
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Telephone | 909-396-5161
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Fax |
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Provider Business Mailing Address
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Address Line | 1241 GRAND AVE SUITE G
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City | DIAMOND BAR
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State | CA
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Zip | 91765-4447
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Country | US
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Telephone | 909-396-5161
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. HECTOR LANDIG
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Credential | D.M.D.
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Telephone | 909-396-5161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 36570
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License Number State | CA
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