Provider Demographics
NPI:1902836703
Name:ADAN, CIRILO LAGMAY JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:CIRILO
Middle Name:LAGMAY
Last Name:ADAN
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:38 GALAXY WAY
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436
Mailing Address - Country:US
Mailing Address - Phone:805-733-4000
Mailing Address - Fax:805-733-4000
Practice Address - Street 1:90 VIA JUANA LANE
Practice Address - Street 2:SANTA YNEZ TRIBAL HEALTH CLINIC
Practice Address - City:SANTA YNEZ
Practice Address - State:CA
Practice Address - Zip Code:93460
Practice Address - Country:US
Practice Address - Phone:805-688-7070
Practice Address - Fax:805-686-2060
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17809122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist