Provider Demographics
NPI:1023722881
Name:DR. MILAGROS A LOO GENERAL DENTISTRY
Entity type:Organization
Organization Name:DR. MILAGROS A LOO GENERAL DENTISTRY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER/ OR ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:DORA
Authorized Official - Middle Name:H
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-346-4411
Mailing Address - Street 1:1194 S. LORENA ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90023
Mailing Address - Country:US
Mailing Address - Phone:323-526-8189
Mailing Address - Fax:323-526-8314
Practice Address - Street 1:1194 S LORENA ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90023
Practice Address - Country:US
Practice Address - Phone:323-526-8189
Practice Address - Fax:323-526-8314
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR. MILAGROS A LOO GENERAL DENTISTRY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-06
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Multi-Specialty