Provider Demographics
NPI:1851677272
Name:GAFFINO AND REAGAN DENTAL CORPORATION
Entity Type:Organization
Organization Name:GAFFINO AND REAGAN DENTAL CORPORATION
Other - Org Name:BREA DENTIST AND ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:P
Authorized Official - Last Name:GAFFINO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-990-2299
Mailing Address - Street 1:2860 MICHELLE DRIVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606
Mailing Address - Country:US
Mailing Address - Phone:714-368-2077
Mailing Address - Fax:714-368-2092
Practice Address - Street 1:2500 EAST IMPERIAL HWY
Practice Address - Street 2:SUITE 120
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821
Practice Address - Country:US
Practice Address - Phone:714-990-2299
Practice Address - Fax:714-990-5193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty