Provider Demographics
NPI:1255484598
Name:CRUZ, JULIO (DDS INC)
Entity Type:Individual
Prefix:DR
First Name:JULIO
Middle Name:
Last Name:CRUZ
Suffix:
Gender:M
Credentials:DDS INC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9210 KATELLA AVE
Mailing Address - Street 2:STE C
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-6376
Mailing Address - Country:US
Mailing Address - Phone:714-952-9541
Mailing Address - Fax:714-952-9142
Practice Address - Street 1:9210 KATELLA AVE
Practice Address - Street 2:STE C
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-6376
Practice Address - Country:US
Practice Address - Phone:714-952-9541
Practice Address - Fax:714-952-9142
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA405661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice