Basic Information
| Provider Information | |||||||||
| NPI: | 1144711524 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DAVID L ANGULO DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4405 W RIVERSIDE DR STE 300 | ||||||||
| Address2: | |||||||||
| City: | BURBANK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 915054050 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188463831 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4405 W RIVERSIDE DR STE 300 | ||||||||
| Address2: | |||||||||
| City: | BURBANK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 915054050 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188463831 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/22/2018 | ||||||||
| LastUpdateDate: | 05/22/2018 | ||||||||
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| AuthorizedOfficialLastName: | ANGULO | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8188463831 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DDS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QD0000X | 30370 | CA | Y | Ambulatory Health Care Facilities | Clinic/Center | Dental |
No ID Information.