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Individual

DR. ANDERSON GUSTAVO ALAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1413 FOOTHILL BLVD, SUITE G, LA VERNE, CA 91750
(909) 593-7561
(909) 447-7004
Mailing address
1413 FOOTHILL BLVD, SUITE G, LA VERNE, CA 91750
(909) 593-7561
(909) 447-7004

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
37775
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
G9285101
DENTI CAL
CA
Enumeration date
08/21/2006
Last updated
07/08/2007
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