Provider Demographics
NPI:1235597303
Name:VITUG, DINAH MAULAWIN (DDS)
Entity Type:Individual
Prefix:
First Name:DINAH
Middle Name:MAULAWIN
Last Name:VITUG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:681 COASTAL HILLS DR
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914-4319
Mailing Address - Country:US
Mailing Address - Phone:619-607-0882
Mailing Address - Fax:619-477-6888
Practice Address - Street 1:1035 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-3515
Practice Address - Country:US
Practice Address - Phone:619-477-0888
Practice Address - Fax:619-477-6888
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-04
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49238122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist