Provider Demographics
NPI:1992884431
Name:CAMONES, VICTOR ROBERTO (DDS)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:ROBERTO
Last Name:CAMONES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16527 MURPHY RD
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-6219
Mailing Address - Country:US
Mailing Address - Phone:562-943-3992
Mailing Address - Fax:
Practice Address - Street 1:15027 MULBERRY DR
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90604-1528
Practice Address - Country:US
Practice Address - Phone:562-906-8868
Practice Address - Fax:562-906-8878
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA433251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice