Provider Demographics
NPI:1538268420
Name:DR. DENNIS E. QUAGLIA D.D.S. INC
Entity type:Organization
Organization Name:DR. DENNIS E. QUAGLIA D.D.S. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:QUAGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:559-299-2168
Mailing Address - Street 1:334 SHAW AVE STE 138
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-3839
Mailing Address - Country:US
Mailing Address - Phone:559-299-2168
Mailing Address - Fax:559-299-1492
Practice Address - Street 1:334 SHAW AVE STE 138
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-3839
Practice Address - Country:US
Practice Address - Phone:559-299-2168
Practice Address - Fax:559-299-1492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty