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General NPI Number Information
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NPI Number | 1659513281
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Entity Type | Organization
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Legal Business Name | MARY F. AQUINO, DMD INC.
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Dates
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Enumeration Date | 03/27/2009
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Last Update Date | 03/27/2009
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Provider Practice Location Address
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Address Line | 16917 DEVONSHIRE ST
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City | GRANADA HILLS
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State | CA
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Zip | 91344-7407
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Country | US
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Telephone | 818-360-0957
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Fax | 818-360-7327
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Provider Business Mailing Address
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Address Line | 16917 DEVONSHIRE ST
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City | GRANADA HILLS
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State | CA
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Zip | 91344-7407
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Country | US
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Telephone | 818-360-0957
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Fax | 818-360-7327
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARY FELICITY TORDECILLA AQUINO
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Credential | DMD
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Telephone | 818-360-0957
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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 | 45085
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License Number State | CA
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