Provider Demographics
NPI:1073151726
Name:LOZA ALARCON, CIRO MARTIN (DDS)
Entity Type:Individual
Prefix:
First Name:CIRO
Middle Name:MARTIN
Last Name:LOZA ALARCON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9304 N GREEN MEADOWS LN
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-0630
Mailing Address - Country:US
Mailing Address - Phone:559-290-0154
Mailing Address - Fax:
Practice Address - Street 1:3127 BALDWIN PARK BLVD
Practice Address - Street 2:
Practice Address - City:BALDWIN PARK
Practice Address - State:CA
Practice Address - Zip Code:91706-4754
Practice Address - Country:US
Practice Address - Phone:626-962-3500
Practice Address - Fax:626-962-3551
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-12
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1046121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice