Ivan Leonard Agnew JR. DDS

NPI 1033222450 - Dentist - 122300000X

NPI Details
NPI 1033222450
Gender Male
Enumeration Date 08/17/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
2332 HARRISON AVE
SUITE B
EUREKA CA, 95501, US
Phone (707) 443-7381
Fax
Business Location
3655 G ST
EUREKA CA, 95503, US
Phone (707) 442-6337
Fax
Toxanomy
Taxonomy Code 122300000X
License State California
License Number 14224
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According to our database, Dr. Ivan Leonard Agnew JR. DDS NPI is 1033222450, taxonomy code is 122300000X and license number is 14224, license state is located at California. Ivan Leonard Agnew JR. DDS physically located at 2332 Harrison Ave, Eureka CA, 95501. NPI Number Ivan Leonard Agnew JR. DDS has the Individual type.

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1033222450 NPI number is provided on an as is basis without warranty of any kind. 1033222450 is maintained by the National Plan & Provider Enumeration System. The contents of Ivan Leonard Agnew JR. DDS are for informational purposes only.