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General NPI Number Information
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NPI Number | 1740436005
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Entity Type | Organization
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Legal Business Name | LEON PARRILLA D.D.S INCORPORATED
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Dates
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Enumeration Date | 08/18/2008
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Last Update Date | 08/19/2008
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Provider Practice Location Address
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Address Line | 114 J ST
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City | BRAWLEY
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State | CA
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Zip | 92227
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Country | US
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Telephone | 760-344-2341
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Fax |
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Provider Business Mailing Address
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Address Line | 114 J ST
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City | BRAWLEY
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State | CA
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Zip | 92227
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Country | US
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Telephone | 760-344-2341
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. NORMA A LUGO
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Credential | RDA
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Telephone | 760-344-2341
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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 | 44979
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License Number State | CA
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