Provider Demographics
NPI:1588971162
Name:EMMANUEL ANGELES, D.D.S., INC.
Entity type:Organization
Organization Name:EMMANUEL ANGELES, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ANGELES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-302-9300
Mailing Address - Street 1:32065 TEMECULA PKWY
Mailing Address - Street 2:#C
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92692
Mailing Address - Country:US
Mailing Address - Phone:951-302-9300
Mailing Address - Fax:951-303-1822
Practice Address - Street 1:32065 TEMECULA PKWY
Practice Address - Street 2:#C
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92692
Practice Address - Country:US
Practice Address - Phone:951-302-9300
Practice Address - Fax:951-303-1822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-03
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55644122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty