Provider Demographics
NPI:1659467058
Name:OR TRIGOSO DENTAL CORPORATION
Entity Type:Organization
Organization Name:OR TRIGOSO DENTAL CORPORATION
Other - Org Name:CERRITOS DENTAL GROUP OF OSCAR R TRIOGOSO DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:R
Authorized Official - Last Name:TRIGOSO
Authorized Official - Suffix:
Authorized Official - Credentials:DENTIST DDS
Authorized Official - Phone:626-915-8122
Mailing Address - Street 1:635 E ARROW HWY
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-5802
Mailing Address - Country:US
Mailing Address - Phone:626-915-8122
Mailing Address - Fax:626-915-0322
Practice Address - Street 1:635 E ARROW HWY
Practice Address - Street 2:
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702-5802
Practice Address - Country:US
Practice Address - Phone:626-915-8122
Practice Address - Fax:626-915-0322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41686122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty