Provider Demographics
NPI:1255460473
Name:UNIVERSITY OF THE PACIFIC ARTHUR A. DUGONI
Entity type:Organization
Organization Name:UNIVERSITY OF THE PACIFIC ARTHUR A. DUGONI
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE DEAN FOR CLINICAL SERVICE
Authorized Official - Prefix:DR
Authorized Official - First Name:SIGMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:ABELSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-929-6604
Mailing Address - Street 1:155 5TH ST
Mailing Address - Street 2:NOT IN USE
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2919
Mailing Address - Country:US
Mailing Address - Phone:415-929-6501
Mailing Address - Fax:
Practice Address - Street 1:155 5TH ST
Practice Address - Street 2:NOT IN USE
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2919
Practice Address - Country:US
Practice Address - Phone:415-929-6501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF THE PACIFIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-05
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG01001-05OtherDENTI-CAL IDENTIFICATION