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General NPI Number Information
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NPI Number | 1952544744
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Entity Type | Organization
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Legal Business Name | GUDINO DENTAL GROUP INC.
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Dates
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Enumeration Date | 04/09/2009
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Last Update Date | 06/13/2011
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Provider Practice Location Address
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Address Line | 11550 ROSECRANS AVE SUITE 102
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City | NORWALK
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State | CA
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Zip | 90650-3802
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Country | US
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Telephone | 562-381-5085
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Fax |
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Provider Business Mailing Address
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Address Line | 11550 ROSECRANS AVE SUITE #102
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City | NORWALK
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State | CA
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Zip | 90650-3802
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Country | US
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Telephone | 562-864-1006
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. AARON DANIEL GUDINO
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Credential | D.D.S.
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Telephone | 562-381-3140
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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 | 58044
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License Number State | CA
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