Individual
DR. VIRGINIA IPAPO AGUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
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
122300000X
Dentist
56593
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
56593
CA
Other
Enumeration date
12/13/2007
Last updated
04/10/2019
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