Organization
GRDENTISTRY GILBERTO OLAGUEDDSAPROFESSIONALCORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GILBERTO OLAGUE DDS (PRESIDENT)
(805) 404-1451
Entity
Organization
Contact information
Practice address
3559 W RAMSEY ST STE C1, BANNING, CA 92220-3505
(951) 922-3993
(951) 922-3991
Mailing address
3559 W RAMSEY ST STE C1, BANNING, CA 92220-3505
(951) 922-3993
(951) 922-3991
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
59467
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427363514
—
CA
Enumeration date
05/24/2014
Last updated
05/24/2014
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