Provider Demographics
NPI:1902463615
Name:N. PANIAGUA DMD, INC
Entity Type:Organization
Organization Name:N. PANIAGUA DMD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:NED
Authorized Official - Middle Name:
Authorized Official - Last Name:PANIAGUA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:909-596-5959
Mailing Address - Street 1:2082 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:LA VERNE
Mailing Address - State:CA
Mailing Address - Zip Code:91750
Mailing Address - Country:US
Mailing Address - Phone:909-596-5959
Mailing Address - Fax:909-596-5911
Practice Address - Street 1:2082 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:LA VERNE
Practice Address - State:CA
Practice Address - Zip Code:91750
Practice Address - Country:US
Practice Address - Phone:909-596-5959
Practice Address - Fax:909-596-5911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental