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General NPI Number Information
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NPI Number | 1821055344
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Entity Type | Individual
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Provider Name | DECIO ANDRADE BARBOSA D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 09/25/2008
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Provider Practice Location Address
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Address Line | 16700 HAWTHORNE BLVD
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City | LAWNDALE
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State | CA
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Zip | 90260-3243
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Country | US
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Telephone | 310-406-3000
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Fax | 310-406-3309
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Provider Business Mailing Address
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Address Line | 16700 HAWTHORNE BLVD
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City | LAWNDALE
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State | CA
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Zip | 90260
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Country | US
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Telephone | 310-406-3000
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Fax | 310-406-3309
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 50207
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License Number State | CA
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