Provider Demographics
NPI:1821270547
Name:VARGAS-LOO, MARIA DULCE MANLY (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARIA DULCE
Middle Name:MANLY
Last Name:VARGAS-LOO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7878 CLAIREMONT MESA BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-1621
Mailing Address - Country:US
Mailing Address - Phone:858-467-1223
Mailing Address - Fax:
Practice Address - Street 1:7878 CLAIREMONT MESA BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1621
Practice Address - Country:US
Practice Address - Phone:858-467-1223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA441181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice