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General NPI Number Information
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NPI Number | 1982007753
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Entity Type | Organization
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Legal Business Name | ERIC OLGUIN DDS, A DENTAL CORPORATION
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Dates
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Enumeration Date | 10/07/2014
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Last Update Date | 12/02/2020
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Provider Practice Location Address
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Address Line | 3750 W MCFADDEN AVE SUITE D
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City | SANTA ANA
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State | CA
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Zip | 92704-1388
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Country | US
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Telephone | 714-775-7722
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Fax | 714-775-6131
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Provider Business Mailing Address
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Address Line | 3750 W MCFADDEN AVE SUITE D
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City | SANTA ANA
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State | CA
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Zip | 92704-1388
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Country | US
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Telephone | 714-775-7722
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Fax | 714-775-6131
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Authorized Official
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Title or Position | OWNER
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Name | ERIC OLGUIN
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Credential | DDS
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Telephone | 714-775-7722
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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 | 45945
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License Number State | CA
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