Provider Demographics
NPI:1205017746
Name:VICTOR R. CAMONES DDS INC
Entity Type:Organization
Organization Name:VICTOR R. CAMONES DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-956-4490
Mailing Address - Street 1:2785 W BALL RD
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-5029
Mailing Address - Country:US
Mailing Address - Phone:714-956-4490
Mailing Address - Fax:
Practice Address - Street 1:2364 W LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-5101
Practice Address - Country:US
Practice Address - Phone:562-906-8868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD433251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty