Provider Demographics
NPI:1528377355
Name:ALBELAIS, AUSTREBERTO BOIDO (DDS)
Entity Type:Individual
Prefix:DR
First Name:AUSTREBERTO
Middle Name:BOIDO
Last Name:ALBELAIS
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 1:1037 S GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-4710
Mailing Address - Country:US
Mailing Address - Phone:626-281-1880
Mailing Address - Fax:626-281-2782
Practice Address - Street 1:1037 S GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-4710
Practice Address - Country:US
Practice Address - Phone:626-281-1880
Practice Address - Fax:626-281-2782
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA238811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice