Rogelio Avalos Barrera, DDS

Individual provider Active NPI General Practice Dentistry · Marysville, CA

NPI 1013930239 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1013930239
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
42274 (CA)
Practice address
812 4TH St
Suite E
Marysville, CA 95901
Phone
(530) 742-6971
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
42274CAMDLicensed Vocational Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 42274 CA Yes

Addresses

Primary practice location

812 4TH St
Suite E
Marysville, CA 95901

Mailing address

812 4TH St
Suite E
Marysville, CA 95901
Phone (530) 742-6971

Other providers in Marysville, CA

All providers in Marysville, CA · General Practice Dentistry in California

Sources for this page

Verify at the official NPI Registry.