DANIEL T. ESTACIO, DDS, INC.
Managed Care Organizations at Chevy Chase Dr, Glendale, CA

License number
California 47886
Category
Managed Care Organizations
Type
Preferred Provider Organization
Owner
Name: DR. DANIEL TORIBIO ESTACIO DDS
Title: DENTIST/PRESIDENT
Phone: (818) 247-3387
Address
Address
1140 E Chevy Chase Dr, Glendale, CA 91205
National Provider ID: 1649467291
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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DANIEL T. ESTACIO, DDS, INC

Glendale, CA  -  Santa Clarita, CA

Registration:
Mar 23, 2005
Addresses:
1140 E Chevy Chase Dr, Glendale, CA 91205 (Physical)
19117 Olympic Crst Dr, Santa Clarita, CA 91351
State ID:
C2735983
Business type:
Articles of Incorporation
President:
Daniel T. Estacio (President)
Agent:
Daniel Estacio,Glendale, CA 91205 (Physical)

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