Provider Demographics
NPI:1528195088
Name:DUENES, ANGELA T (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:T
Last Name:DUENES
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 1:3502 COLLEGE BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056
Mailing Address - Country:US
Mailing Address - Phone:760-941-7502
Mailing Address - Fax:760-940-2704
Practice Address - Street 1:3502 COLLEGE BLVD
Practice Address - Street 2:STE B
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056
Practice Address - Country:US
Practice Address - Phone:760-941-7502
Practice Address - Fax:760-940-2704
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38987122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG9139801OtherMEDICAL