Provider Demographics
NPI:1376097436
Name:SAUCEDO, HECTOR (DDS)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:
Last Name:SAUCEDO
Suffix:
Gender:M
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:AVE. LOPEZ MATEOS 1524
Mailing Address - Street 2:SUITE 1
Mailing Address - City:JUAREZ
Mailing Address - State:CHIHUAHUA
Mailing Address - Zip Code:32310
Mailing Address - Country:MX
Mailing Address - Phone:915-407-8394
Mailing Address - Fax:
Practice Address - Street 1:AVE. LOPEZ MATEOS 1524
Practice Address - Street 2:SUITE 1
Practice Address - City:JUAREZ
Practice Address - State:CHIHUAHUA
Practice Address - Zip Code:32310
Practice Address - Country:MX
Practice Address - Phone:915-407-8394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-06
Last Update Date:2016-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ5864536122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist