Provider Demographics
NPI:1093837064
Name:DE LEON, MARIA CRISTINA S (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARIA CRISTINA
Middle Name:S
Last Name:DE LEON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19231 VICTORY BLVD
Mailing Address - Street 2:SUITE 451
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-6308
Mailing Address - Country:US
Mailing Address - Phone:818-345-3355
Mailing Address - Fax:818-345-3563
Practice Address - Street 1:19231 VICTORY BLVD
Practice Address - Street 2:SUITE 451
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-6308
Practice Address - Country:US
Practice Address - Phone:818-345-3355
Practice Address - Fax:818-345-3563
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA384141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice