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NPI Code Detail

MEDICARE: DR. JULIO ULISES TERRA DDS

MEDICARE: DR. JULIO ULISES TERRA 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
11223G0001XGeneral Practice Dentistry49683CA

General Provider Information

NPI Number : 1568583672
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JULIO ULISES TERRA DDS
Provider Business Mailing Address
First Line : 5220 E LOS ALTOS PLZ
Second Line :
City : LONG BEACH
State : CA
Zip : 90815-4251
Country : US
Telephone Number : 562-968-9995
Fax Number : 562-698-1376
Provider Business Practice Location Address
First Line : 5220 E LOS ALTOS PLZ
Second Line :
City : LONG BEACH
State : CA
Zip : 90815-4251
Country : US
Telephone Number : 562-968-9995
Fax Number : 562-698-1376
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2007
Last Update Date : 05/13/2009

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