MEDICARE: DENNIS SHO EGUCHI D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	CA027605	CA

General Provider Information

NPI Number	:	1194997478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENNIS SHO EGUCHI D.D.S.

Provider Business Mailing Address
First Line	:	361 ARBOL DR
Second Line	:
City	:	WATSONVILLE
State	:	CA
Zip	:	95076-2758
Country	:	US
Telephone Number	:	831-761-2556
Fax Number	:

Provider Business Practice Location Address
First Line	:	390 S GREEN VALLEY RD
Second Line	:	SUITE #3
City	:	WATSONVILLE
State	:	CA
Zip	:	95076-3077
Country	:	US
Telephone Number	:	831-728-0444
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2008
Last Update Date	:	03/27/2008

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