Provider Demographics
NPI:1528241163
Name:MAGAR, MARCOS (DDS)
Entity type:Individual
Prefix:DR
First Name:MARCOS
Middle Name:
Last Name:MAGAR
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 1:7119 SEVILLE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-4905
Mailing Address - Country:US
Mailing Address - Phone:323-589-7777
Mailing Address - Fax:323-589-7777
Practice Address - Street 1:7119 SEVILLE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-4905
Practice Address - Country:US
Practice Address - Phone:323-589-7777
Practice Address - Fax:323-589-7777
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA566581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice