Provider Demographics
NPI:1174816870
Name:ORTEGA, JULIO CRUZ (DDS)
Entity Type:Individual
Prefix:DR
First Name:JULIO
Middle Name:CRUZ
Last Name:ORTEGA
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 1:9509 CENTRAL AVE STE D
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-2400
Mailing Address - Country:US
Mailing Address - Phone:909-399-3330
Mailing Address - Fax:
Practice Address - Street 1:9509 CENTRAL AVE STE D
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-2400
Practice Address - Country:US
Practice Address - Phone:909-399-3330
Practice Address - Fax:909-399-9888
Is Sole Proprietor?:No
Enumeration Date:2011-05-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61485122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist