Provider Demographics
NPI:1568182053
Name:ARCINIEGA, MARIA LAURA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:LAURA
Last Name:ARCINIEGA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1008 N ORANGE BLOSSOM AVE
Mailing Address - Street 2:
Mailing Address - City:LA PUENTE
Mailing Address - State:CA
Mailing Address - Zip Code:91746-1238
Mailing Address - Country:US
Mailing Address - Phone:626-510-4129
Mailing Address - Fax:
Practice Address - Street 1:732 MOTT ST STE 100-110
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-4237
Practice Address - Country:US
Practice Address - Phone:818-963-5690
Practice Address - Fax:818-361-3440
Is Sole Proprietor?:No
Enumeration Date:2022-09-02
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA1079331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice