Provider Demographics
NPI:1730564501
Name:SARAH A CUPINO DMD INC
Entity type:Organization
Organization Name:SARAH A CUPINO DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:FIDEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CUPINO
Authorized Official - Suffix:
Authorized Official - Credentials:PE
Authorized Official - Phone:562-881-1615
Mailing Address - Street 1:12146 SOUTH ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701-6844
Mailing Address - Country:US
Mailing Address - Phone:562-924-1007
Mailing Address - Fax:562-924-1267
Practice Address - Street 1:12146 SOUTH ST
Practice Address - Street 2:SUITE E
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701-6844
Practice Address - Country:US
Practice Address - Phone:562-924-1007
Practice Address - Fax:562-924-1267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS 41910251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare