Organization
VIRGINIA IPAPO-AGUSTIN DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA IPAPO AGUSTIN (PRESIDENT)
(626) 336-4453
Entity
Organization
Contact information
Practice address
525 N AZUSA AVE STE 112, LA PUENTE, CA 91744-4261
(626) 336-4453
Mailing address
525 N AZUSA AVE STE 112, LA PUENTE, CA 91744-4261
(626) 336-4453
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
04/10/2019
Last updated
04/10/2019
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