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General NPI Number Information
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NPI Number | 1952018814
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Entity Type | Individual
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Provider Name | GLORIA UMUTANGANA DDS
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Gender | Female
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Dates
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Enumeration Date | 10/31/2022
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Last Update Date | 10/31/2022
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Provider Practice Location Address
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Address Line | 18107 SHERMAN WAY STE 107
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City | RESEDA
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State | CA
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Zip | 91335-8803
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Country | US
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Telephone | 818-600-8920
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Fax |
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Provider Business Mailing Address
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Address Line | 27320 DUXBURY PL
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City | VALENCIA
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State | CA
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Zip | 91354-1929
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Country | US
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Telephone | 323-506-0966
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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 | 39013
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License Number State | TX
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