Provider Demographics
NPI:1043380975
Name:CRUZ, MAY EVELYN (DDS)
Entity Type:Individual
Prefix:MS
First Name:MAY
Middle Name:EVELYN
Last Name:CRUZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1464 SPRINGVALE ST
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-3766
Mailing Address - Country:US
Mailing Address - Phone:909-629-5061
Mailing Address - Fax:909-629-5061
Practice Address - Street 1:1357 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-5815
Practice Address - Country:US
Practice Address - Phone:909-635-3736
Practice Address - Fax:909-635-3738
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA431341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice