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General NPI Number Information
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NPI Number | 1518321355
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Entity Type | Organization
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Legal Business Name | RINGO V. BANGALAN DDS DENTAL CORP
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Dates
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Enumeration Date | 04/07/2016
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Last Update Date | 04/07/2016
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Provider Practice Location Address
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Address Line | 15618 GALE AVE
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City | HACIENDA HEIGHTS
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State | CA
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Zip | 91745-1514
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Country | US
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Telephone | 626-961-8878
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Fax | 626-961-8836
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Provider Business Mailing Address
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Address Line | 15618 GALE AVE
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City | HACIENDA HEIGHTS
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State | CA
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Zip | 91745-1514
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Country | US
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Telephone | 626-961-8878
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Fax | 626-961-8838
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RINGO V BANGALAN
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Credential | DDS
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Telephone | 626-961-8878
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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 | 55678
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License Number State | CA
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