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General NPI Number Information
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NPI Number | 1013616598
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Entity Type | Individual
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Provider Name | EVELYN BRIDGET CRUZ SNEED DDS
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Gender | Female
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Dates
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Enumeration Date | 02/23/2023
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 2411 N BROADWAY
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City | LOS ANGELES
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State | CA
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Zip | 90031-2218
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Country | US
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Telephone | 323-254-5291
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Fax |
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Provider Business Mailing Address
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Address Line | 162 S AVENUE 55 APT 1
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City | LOS ANGELES
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State | CA
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Zip | 90042-5066
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Country | US
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Telephone | 562-544-7029
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DDS110005
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License Number State | CA
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