Individual
MR. DANIEL TORIBIO ESTACIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1140 E CHEVY CHASE DR, GLENDALE, CA 91205-2511
(818) 247-3387
(818) 247-2680
Mailing address
1140 E CHEVY CHASE DR, GLENDALE, CA 91205-2511
(818) 247-3387
(818) 247-2680
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
47886
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G-93853-01
MEDI-CAL PROVIDER NUMBER
CA
Enumeration date
03/28/2007
Last updated
10/02/2014
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