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General NPI Number Information
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NPI Number | 1619611548
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Entity Type | Individual
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Provider Name | EMILIO FRIAS DDS
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Gender | Male
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Dates
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Enumeration Date | 04/26/2022
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Last Update Date | 04/26/2022
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Provider Practice Location Address
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Address Line | 320 NEWTON ST APT 2
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City | SAN FERNANDO
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State | CA
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Zip | 91340-3060
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Country | US
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Telephone | 818-675-3563
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Fax |
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Provider Business Mailing Address
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Address Line | 320 NEWTON ST APT 2
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City | SAN FERNANDO
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State | CA
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Zip | 91340-3060
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Country | US
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Telephone |
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Fax |
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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 | 107373
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License Number State | CA
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