Provider Demographics
NPI:1225572704
Name:GARY P. OCAMPO D.D.S. INC.
Entity Type:Organization
Organization Name:GARY P. OCAMPO D.D.S. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARRY
Authorized Official - Middle Name:P
Authorized Official - Last Name:OCAMPO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-424-4434
Mailing Address - Street 1:2355 PACIFIC AVE STE C
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-6700
Mailing Address - Country:US
Mailing Address - Phone:562-424-4434
Mailing Address - Fax:562-595-1666
Practice Address - Street 1:2355 PACIFIC AVE STE C
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-6700
Practice Address - Country:US
Practice Address - Phone:562-424-4434
Practice Address - Fax:562-595-1666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41501122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty