Provider Demographics
NPI:1134302763
Name:VASQUEZ, DIANA CRISTINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:CRISTINA
Last Name:VASQUEZ
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 1:860 KUHN DR STE 203
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914-4517
Mailing Address - Country:US
Mailing Address - Phone:619-482-4237
Mailing Address - Fax:619-656-6464
Practice Address - Street 1:860 KUHN DR STE 203
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-4517
Practice Address - Country:US
Practice Address - Phone:619-656-9393
Practice Address - Fax:619-656-6464
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA559291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice