Jacinto, Russel R
Jacinto, Russel R is an sole proprietor health care provider with primary practice located at 144 N Glendale Ave #100, Glendale CA 91206-4903. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Jacinto, Russel R can be contacted via phone (818) 240-6705.Contact Information
Primary practice address
144 N Glendale Ave #100
Glendale CA 91206-4903
Phone: (818) 240-6705
Fax: (818) 240-3758
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 37841 | California |
Profile Details
| NPI number | 1578610903 |
|---|---|
| LBN Legal business name | Jacinto, Russel R |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 5th, 2007 |
| Last updated | Jun 18th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578610903 | NPPES |
| California | Other | 1578610903 | MEDI CAL |
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