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General NPI Number Information
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NPI Number | 1871837013
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Entity Type | Organization
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Legal Business Name | GIRLIE AQUINO UY DDS INC.
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Dates
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Enumeration Date | 11/11/2012
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Last Update Date | 11/11/2012
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Provider Practice Location Address
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Address Line | 9867 MAGNOLIA AVE STE E
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City | RIVERSIDE
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State | CA
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Zip | 92503-3519
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Country | US
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Telephone | 951-352-2112
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Fax | 951-352-2088
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Provider Business Mailing Address
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Address Line | 9867 MAGNOLIA AVE STE E
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City | RIVERSIDE
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State | CA
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Zip | 92503-3519
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Country | US
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Telephone | 951-352-2112
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Fax | 951-352-2088
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GIRLIE AQUINO UY
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Credential | DDS
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Telephone | 951-352-2112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 56967
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 56967
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 56967
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License Number State | CA
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