Provider Demographics
NPI:1871837013
Name:GIRLIE AQUINO UY DDS INC.
Entity Type:Organization
Organization Name:GIRLIE AQUINO UY DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GIRLIE
Authorized Official - Middle Name:AQUINO
Authorized Official - Last Name:UY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-352-2112
Mailing Address - Street 1:9867 MAGNOLIA AVE STE E
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-3519
Mailing Address - Country:US
Mailing Address - Phone:951-352-2112
Mailing Address - Fax:951-352-2088
Practice Address - Street 1:9867 MAGNOLIA AVE STE E
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3519
Practice Address - Country:US
Practice Address - Phone:951-352-2112
Practice Address - Fax:951-352-2088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-11
Last Update Date:2012-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56967302R00000X, 305R00000X, 305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No305S00000XManaged Care OrganizationsPoint of Service