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General NPI Number Information
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NPI Number | 1982974184
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Entity Type | Organization
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Legal Business Name | BUENA DENTAL GROUP
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Dates
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Enumeration Date | 01/04/2012
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Last Update Date | 01/04/2012
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Provider Practice Location Address
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Address Line | 421 S VENTURA RD STE. 40
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City | OXNARD
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State | CA
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Zip | 93030-6551
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Country | US
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Telephone | 805-382-8000
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Fax | 805-382-8002
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Provider Business Mailing Address
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Address Line | PO BOX 312 STE. 40
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City | OXNARD
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State | CA
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Zip | 93032-0312
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Country | US
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Telephone | 805-382-8000
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Fax | 805-382-8002
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Authorized Official
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Title or Position | DENTIST /PARTNER
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Name | GUILLERMO FUJIMURA
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Credential |
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Telephone | 805-382-8000
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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 | 38283
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License Number State | CA
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