Provider Demographics
NPI:1346462454
Name:FUCHS, ALLA (DDS)
Entity Type:Individual
Prefix:MRS
First Name:ALLA
Middle Name:
Last Name:FUCHS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7441 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LEMON GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:91945-1603
Mailing Address - Country:US
Mailing Address - Phone:619-464-2944
Mailing Address - Fax:619-464-2952
Practice Address - Street 1:7441 BROADWAY
Practice Address - Street 2:
Practice Address - City:LEMON GROVE
Practice Address - State:CA
Practice Address - Zip Code:91945-1603
Practice Address - Country:US
Practice Address - Phone:619-464-2944
Practice Address - Fax:619-464-2952
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA311311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB3113101OtherMEDI CAL