Provider Demographics
NPI:1437378437
Name:PARICO-BAUTISTA, CECIL GARCIA (DDS)
Entity Type:Individual
Prefix:
First Name:CECIL
Middle Name:GARCIA
Last Name:PARICO-BAUTISTA
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 1:4837 HUNTINGTON DR N STE 8
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90032-1953
Mailing Address - Country:US
Mailing Address - Phone:323-223-7200
Mailing Address - Fax:323-223-7500
Practice Address - Street 1:4837 HUNTINGTON DR N STE 8
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90032-1953
Practice Address - Country:US
Practice Address - Phone:323-223-7200
Practice Address - Fax:323-223-7500
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52766122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist