Provider Demographics
NPI:1124427224
Name:ANGARITA, GISELLA ML (DDS)
Entity type:Individual
Prefix:DR
First Name:GISELLA
Middle Name:ML
Last Name:ANGARITA
Suffix:
Gender:F
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:PO BOX 1878
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91785-1878
Mailing Address - Country:US
Mailing Address - Phone:909-229-9209
Mailing Address - Fax:909-483-0973
Practice Address - Street 1:848 N EUCLID AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-2730
Practice Address - Country:US
Practice Address - Phone:909-984-1576
Practice Address - Fax:909-483-0973
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41340122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist