Provider Demographics
NPI:1245585736
Name:GASPAR, DOMINIC ARIAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:DOMINIC
Middle Name:ARIAS
Last Name:GASPAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10111 ADAMS AVE STE 111
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-4900
Mailing Address - Country:US
Mailing Address - Phone:714-963-3555
Mailing Address - Fax:714-963-3550
Practice Address - Street 1:10111 ADAMS AVE STE 111
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92646-4900
Practice Address - Country:US
Practice Address - Phone:714-963-3555
Practice Address - Fax:714-963-3550
Is Sole Proprietor?:No
Enumeration Date:2012-07-20
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA615611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice