Provider Demographics
NPI:1417014085
Name:GUARING BAGAY, BERNADETTE LUYUN (DDS)
Entity Type:Individual
Prefix:DR
First Name:BERNADETTE
Middle Name:LUYUN
Last Name:GUARING BAGAY
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 1:984 E BADILLO ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91724
Mailing Address - Country:US
Mailing Address - Phone:626-859-5715
Mailing Address - Fax:626-859-5717
Practice Address - Street 1:984 E BADILLO ST
Practice Address - Street 2:SUITE E
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91724
Practice Address - Country:US
Practice Address - Phone:626-859-5715
Practice Address - Fax:626-859-5717
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44482122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist