Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 0401412395 | VA |
NPI | 1063647824 |
---|---|
Provider Name | Luis D Arango |
First Address | Virginia Beach, VA 23464-8875 |
Second Address | Virginia Beach, VA 23464-8875 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2009 |
Last Update Date | 19/01/2022 |