Provider Demographics
NPI:1326174970
Name:ROSALES, VICTOR MAGPILI (DDS)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:MAGPILI
Last Name:ROSALES
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 1:20530 E ARROW HWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91724-1238
Mailing Address - Country:US
Mailing Address - Phone:626-938-1236
Mailing Address - Fax:626-938-1234
Practice Address - Street 1:20530 E ARROW HWY
Practice Address - Street 2:SUITE A
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91724-1238
Practice Address - Country:US
Practice Address - Phone:626-938-1236
Practice Address - Fax:626-938-1234
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA553691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG89426OtherMEDICAL/DENTI-CAL