Provider Demographics
NPI:1811034341
Name:GISELLA M.L. ANGARITA DDS,APC
Entity Type:Organization
Organization Name:GISELLA M.L. ANGARITA DDS,APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GISELLA
Authorized Official - Middle Name:ML
Authorized Official - Last Name:ANGARITA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-984-1576
Mailing Address - Street 1:848 N EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-2730
Mailing Address - Country:US
Mailing Address - Phone:909-984-1576
Mailing Address - Fax:909-391-1517
Practice Address - Street 1:848 N EUCLID AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-2730
Practice Address - Country:US
Practice Address - Phone:909-984-1576
Practice Address - Fax:909-391-1517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA413401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty