MEDICARE: DR. EUGENE RUSSELL KAPLAN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0300X	Periodontics	19232	CA

General Provider Information

NPI Number	:	1568465219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EUGENE RUSSELL KAPLAN DDS

Provider Business Mailing Address
First Line	:	1777 N BELLFLOWER BLVD
Second Line	:	STE 209
City	:	LONG BEACH
State	:	CA
Zip	:	90815-4020
Country	:	US
Telephone Number	:	562-597-3629
Fax Number	:

Provider Business Practice Location Address
First Line	:	1777 N BELLFLOWER BLVD
Second Line	:	STE 209
City	:	LONG BEACH
State	:	CA
Zip	:	90815-4020
Country	:	US
Telephone Number	:	562-597-3629
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	03/23/2011

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