Provider Demographics
NPI:1417411554
Name:LUIS PINTO D.D.S. A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:LUIS PINTO D.D.S. A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:ALEXANDRINO
Authorized Official - Last Name:PINTO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-767-3601
Mailing Address - Street 1:215 N STATE COLLEGE BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806-2933
Mailing Address - Country:US
Mailing Address - Phone:714-772-2840
Mailing Address - Fax:
Practice Address - Street 1:215 N STATE COLLEGE BLVD STE F
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92806-2933
Practice Address - Country:US
Practice Address - Phone:714-772-2840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental