Provider Demographics
NPI:1275708216
Name:EVELYN V. CATUIRA , D.D.S. INC.
Entity Type:Organization
Organization Name:EVELYN V. CATUIRA , D.D.S. INC.
Other - Org Name:CATUIRA FAMILY DENTISTRY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER / DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:V
Authorized Official - Last Name:CATUIRA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-396-5111
Mailing Address - Street 1:966 N DIAMOND BAR BLVD
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-1040
Mailing Address - Country:US
Mailing Address - Phone:909-396-5111
Mailing Address - Fax:909-396-5115
Practice Address - Street 1:966 N DIAMOND BAR BLVD
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-1040
Practice Address - Country:US
Practice Address - Phone:909-396-5111
Practice Address - Fax:909-396-5115
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EVELYN V. CATUIRA , D.D.S.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA472371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty