Organization
MARIVIC C AGONCILLO DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIVIC C AGONCILLO DDS (OWNER / DENTIST)
(650) 731-0625
Entity
Organization
Contact information
Practice address
343 GELLERT BLVD STE G, DALY CITY, CA 94015-2620
(650) 731-0625
(650) 997-3542
Mailing address
343 GELLERT BLVD STE G, DALY CITY, CA 94015-2620
(650) 731-0625
(650) 997-3542
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/25/2025
Last updated
08/25/2025
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