Provider Demographics
NPI:1740331289
Name:CABRAL, ANGELICA A (DMD,DDS)
Entity type:Individual
Prefix:DR
First Name:ANGELICA
Middle Name:A
Last Name:CABRAL
Suffix:
Gender:F
Credentials:DMD,DDS
Other - Prefix:DR
Other - First Name:ANGELICA
Other - Middle Name:A
Other - Last Name:CABRAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD,DDS
Mailing Address - Street 1:1581 MOLITOR RD
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94002-3713
Mailing Address - Country:US
Mailing Address - Phone:650-273-3078
Mailing Address - Fax:
Practice Address - Street 1:115 BERKELEY SQ
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-1206
Practice Address - Country:US
Practice Address - Phone:510-649-4840
Practice Address - Fax:510-649-3799
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA340311223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics