Provider Demographics
NPI:1366598708
Name:RECIO, ASTER C (DDS)
Entity type:Individual
Prefix:DR
First Name:ASTER
Middle Name:C
Last Name:RECIO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 W BURBANK BLVD STE T
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-1450
Mailing Address - Country:US
Mailing Address - Phone:818-841-6463
Mailing Address - Fax:818-841-6467
Practice Address - Street 1:916 W BURBANK BLVD STE T
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-1450
Practice Address - Country:US
Practice Address - Phone:818-841-6463
Practice Address - Fax:818-841-6467
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA352361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice