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Individual

ANGELO CACCIATORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
131 W ONTARIO AVE STE 102, CORONA, CA 92882-5274
(951) 734-4543
Mailing address
8619 GLASS GEM DR, SAN ANTONIO, TX 78249-4656
(917) 468-5582

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D12091
OR
1223G0001X
General Practice Dentistry
37501
TX
1223P0221X
Pediatric Dentistry
Primary
112746
CA

Other

Enumeration date
07/26/2021
Last updated
04/14/2026
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