Provider Demographics
NPI:1043423742
Name:AMEXUS MEXICO INC.
Entity Type:Organization
Organization Name:AMEXUS MEXICO INC.
Other - Org Name:AMEXUS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:TOVAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-758-8075
Mailing Address - Street 1:3045 S ARCHIBALD AVE
Mailing Address - Street 2:SUITE H-289
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-9001
Mailing Address - Country:US
Mailing Address - Phone:909-758-8075
Mailing Address - Fax:
Practice Address - Street 1:3045 S ARCHIBALD AVE
Practice Address - Street 2:SUITE H-289
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-9001
Practice Address - Country:US
Practice Address - Phone:909-758-8075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty