Provider Demographics
NPI:1841300910
Name:MOGAVERO, FRANK JOSEPH (DDS MS)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:JOSEPH
Last Name:MOGAVERO
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Gender:M
Credentials:DDS MS
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Mailing Address - Street 1:1031 AVENIDA PICO
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-6352
Mailing Address - Country:US
Mailing Address - Phone:949-373-3737
Mailing Address - Fax:949-373-3779
Practice Address - Street 1:1031 AVENIDA PICO
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-6352
Practice Address - Country:US
Practice Address - Phone:949-373-3737
Practice Address - Fax:949-373-3779
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2009-02-12
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Provider Licenses
StateLicense IDTaxonomies
CA362651223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics