Provider Demographics
NPI:1275776502
Name:ANGELOVA, DRAGANA (DDS)
Entity Type:Individual
Prefix:
First Name:DRAGANA
Middle Name:
Last Name:ANGELOVA
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 1:2714 TAHOE BASIN
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-6920
Mailing Address - Country:US
Mailing Address - Phone:909-913-2123
Mailing Address - Fax:
Practice Address - Street 1:1111 HIGHWAY 6
Practice Address - Street 2:SUITE 140
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4914
Practice Address - Country:US
Practice Address - Phone:281-265-3567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-16
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58193122300000X
TX28683122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist