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Individual

MR. XAVER BONDOC PANGILINAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RDH

Contact information

Practice address
1423 E GAGE AVE, SUITE A, LOS ANGELES, CA 90001-1771
(323) 983-4000
(323) 983-4007
Mailing address
16056 LANCET DR, WHITTIER, CA 90603-2597
(310) 951-6193

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
30965
CA
126800000X
Dental Assistant
70539
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
30965
DHCC
CA
01
70539
RDA LICENSE
CA
Enumeration date
01/20/2009
Last updated
03/17/2017
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