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General NPI Number Information
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NPI Number | 1043368269
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Entity Type | Organization
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Legal Business Name | JULIO CRUZ DDS INC
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9210 KATELLA AVE STE C
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City | ANAHEIM
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State | CA
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Zip | 92804-6376
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Country | US
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Telephone | 714-952-9541
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Fax | 714-952-9142
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Provider Business Mailing Address
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Address Line | 9210 KATELLA AVE STE C
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City | ANAHEIM
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State | CA
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Zip | 92804-6376
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Country | US
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Telephone | 714-952-9541
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Fax | 714-952-9142
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JULIO CRUZ
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Credential | DDS
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Telephone | 714-952-9541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 40566
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License Number State | CA
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