Provider Demographics
NPI:1265629646
Name:ABARCA, DANIEL V (DDS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:V
Last Name:ABARCA
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 1:241 W COMPTON BLVD
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90220-3108
Mailing Address - Country:US
Mailing Address - Phone:310-764-2555
Mailing Address - Fax:310-764-0091
Practice Address - Street 1:241 W COMPTON BLVD
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220-3108
Practice Address - Country:US
Practice Address - Phone:310-764-2555
Practice Address - Fax:310-764-0091
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-28
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD389531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice