Provider Demographics
NPI:1225241227
Name:MARGARITA DENTAL GROUP
Entity Type:Organization
Organization Name:MARGARITA DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HUEY
Authorized Official - Middle Name:Q
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-461-7470
Mailing Address - Street 1:39400 MURRIETA HOT SPRINGS RD
Mailing Address - Street 2:SUITE 123-B
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-7707
Mailing Address - Country:US
Mailing Address - Phone:951-461-7470
Mailing Address - Fax:951-461-7480
Practice Address - Street 1:39400 MURRIETA HOT SPRINGS RD
Practice Address - Street 2:SUITE 123-B
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-7707
Practice Address - Country:US
Practice Address - Phone:951-461-7470
Practice Address - Fax:951-461-7480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA443711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty