Provider Demographics
NPI:1932405156
Name:MAGARRO, LEONEL EDU (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEONEL
Middle Name:EDU
Last Name:MAGARRO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1251 S MEADOW LN APT 170
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-6443
Mailing Address - Country:US
Mailing Address - Phone:909-433-0638
Mailing Address - Fax:
Practice Address - Street 1:1970 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-5202
Practice Address - Country:US
Practice Address - Phone:951-213-3450
Practice Address - Fax:951-213-3449
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-04
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA601511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice