Dizon, Marie Beverly

Dizon, Marie Beverly is an sole proprietor health care provider with primary practice located at 1516 Stardust Dr , West Covina CA 91790-4558. She recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is her primary health care specialty. Dizon, Marie Beverly can be contacted via phone (626) 643-6911.

Contact Information

Primary practice address
1516 Stardust Dr West Covina CA 91790-4558
Phone: (626) 643-6911
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 63959 California
Dental Providers / Pediatric Dentistry 1223P0221X 63959 California

Profile Details

NPI number 1275989659
LBN Legal business name Dizon, Marie Beverly
Credentials D.D.S., M.S.
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 4th, 2016
Last updated Mar 2nd, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275989659 NPPES
California Other 63959 CA DENTAL LICENSE

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