Provider Demographics
NPI:1376627901
Name:JUARROS, DANIEL JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:JUARROS
Suffix:JR
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 1:9230 BRUCEVILLE RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-5996
Mailing Address - Country:US
Mailing Address - Phone:916-683-6020
Mailing Address - Fax:916-683-6068
Practice Address - Street 1:9230 BRUCEVILLE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-5996
Practice Address - Country:US
Practice Address - Phone:916-683-6020
Practice Address - Fax:916-683-6068
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA408401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice