Provider Demographics
NPI:1265834527
Name:DUC DO DDS INC.
Entity Type:Organization
Organization Name:DUC DO DDS INC.
Other - Org Name:JUST DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DUC
Authorized Official - Middle Name:H
Authorized Official - Last Name:DO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-862-8239
Mailing Address - Street 1:6012 FLORENCE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:BELL GARDENS
Mailing Address - State:CA
Mailing Address - Zip Code:90201-4737
Mailing Address - Country:US
Mailing Address - Phone:562-927-9548
Mailing Address - Fax:
Practice Address - Street 1:10512 BOLSA AVE STE 103
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-6727
Practice Address - Country:US
Practice Address - Phone:714-265-1833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DUC DO DDS INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA464701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1568674950OtherDENTICAL