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General NPI Number Information
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NPI Number | 1558698092
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Entity Type | Individual
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Provider Name | DEO SOSITO CRUZ DDS
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Gender | Male
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Dates
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Enumeration Date | 11/04/2009
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Last Update Date | 07/18/2015
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Provider Practice Location Address
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Address Line | 3177 OCEANVIEW BLVD.
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City | SAN DIEGO
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State | CA
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Zip | 92113
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Country | US
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Telephone | 619-662-4100
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Fax | 619-231-6073
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Provider Business Mailing Address
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Address Line | 1275 30TH ST.
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City | SAN DIEGO
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State | CA
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Zip | 92154
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Country | US
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Telephone | 619-662-4100
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Fax | 619-231-6073
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 55827
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License Number State | CA
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