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Individual
DR. ROBERT DOMINGUEZ
Active
Individual
DR. ROBERT DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
25510
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
77166
UNITED CONCORDIA
—
Enumeration date
08/04/2006
Last updated
07/08/2007
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