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General NPI Number Information
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NPI Number | 1801451398
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Entity Type | Organization
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Legal Business Name | MARILOU TOQUERO DENTAL CORP
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Dates
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Enumeration Date | 05/09/2019
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Last Update Date | 05/09/2019
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Provider Practice Location Address
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Address Line | 3203 CARSON ST SUITE 2
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City | LAKEWOOD
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State | CA
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Zip | 90712
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Country | US
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Telephone | 818-237-8619
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Fax |
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Provider Business Mailing Address
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Address Line | 3203 CARSON ST SUITE 2
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City | LAKEWOOD
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State | CA
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Zip | 90712-4052
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Country | US
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Telephone | 562-496-1888
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Fax |
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Authorized Official
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Title or Position | DENTIST/CEO
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Name | MARILOU SINGAYAN TOQUERO
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Credential | DDS
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Telephone | 818-237-8619
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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