Provider Demographics
NPI:1275798340
Name:RONALD L. GARIBALDI DDS A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:RONALD L. GARIBALDI DDS A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GARIBALDI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-332-3919
Mailing Address - Street 1:472 W BADILLO ST
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-1829
Mailing Address - Country:US
Mailing Address - Phone:626-332-3919
Mailing Address - Fax:
Practice Address - Street 1:472 W BADILLO ST
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-1829
Practice Address - Country:US
Practice Address - Phone:626-332-3919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty