Provider Demographics
NPI:1518170786
Name:OLGA M AGUINAGA DDS INC.
Entity type:Organization
Organization Name:OLGA M AGUINAGA DDS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUINAGA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-875-5519
Mailing Address - Street 1:580 W FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:RIALTO
Mailing Address - State:CA
Mailing Address - Zip Code:92376-4859
Mailing Address - Country:US
Mailing Address - Phone:909-875-5519
Mailing Address - Fax:909-875-5582
Practice Address - Street 1:580 W FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-4859
Practice Address - Country:US
Practice Address - Phone:909-875-5519
Practice Address - Fax:909-875-5582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB373801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty