Provider Demographics
NPI:1316065543
Name:ARREOLA, ERNIE (RDHAP)
Entity type:Individual
Prefix:
First Name:ERNIE
Middle Name:
Last Name:ARREOLA
Suffix:
Gender:M
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1590 CABRILLO AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-3705
Mailing Address - Country:US
Mailing Address - Phone:408-329-2551
Mailing Address - Fax:
Practice Address - Street 1:1590 CABRILLO AVE
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-3705
Practice Address - Country:US
Practice Address - Phone:408-329-2551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA166124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist