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General NPI Number Information
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NPI Number | 1508436262
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Entity Type | Organization
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Legal Business Name | JUAN JOSE HIDALGO VILLACORTA DDS, INC
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Dates
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Enumeration Date | 06/25/2021
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Last Update Date | 11/18/2023
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Provider Practice Location Address
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Address Line | 1732 W MEDICAL CENTER DR
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City | ANAHEIM
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State | CA
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Zip | 92801-1801
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Country | US
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Telephone | 541-513-3350
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Fax |
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Provider Business Mailing Address
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Address Line | 7 SNOWAPPLE
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City | IRVINE
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State | CA
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Zip | 92614-7412
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Country | US
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Telephone | 541-513-3350
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | LEANN HIDALGO
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Credential |
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Telephone | 657-254-0003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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