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General NPI Number Information
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NPI Number | 1922660448
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Entity Type | Individual
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Provider Name | FRED ANDREW FLORES ARINO DMD
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Gender | Male
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Dates
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Enumeration Date | 07/04/2019
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Last Update Date | 07/04/2019
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Provider Practice Location Address
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Address Line | 330 W OREGON AVE STE H
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City | PHILADELPHIA
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State | PA
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Zip | 19148-4723
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Country | US
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Telephone | 215-467-3190
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Fax |
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Provider Business Mailing Address
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Address Line | 2040 FAIR PARK AVE APT 105
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City | LOS ANGELES
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State | CA
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Zip | 90041-1986
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Country | US
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Telephone | 323-715-7577
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DS041986
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License Number State | PA
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