Provider Demographics
NPI:1588763460
Name:GAVRILA, MARGARETA M (DDS)
Entity type:Individual
Prefix:DR
First Name:MARGARETA
Middle Name:M
Last Name:GAVRILA
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 1:12850 10TH ST
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-4293
Mailing Address - Country:US
Mailing Address - Phone:909-628-3912
Mailing Address - Fax:909-591-7828
Practice Address - Street 1:12850 10TH ST
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-4293
Practice Address - Country:US
Practice Address - Phone:909-628-3912
Practice Address - Fax:909-591-7828
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3308890741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice