Provider Demographics
NPI:1477624203
Name:OGURA, TERRY T (DDS)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:T
Last Name:OGURA
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 1:550 W DUARTE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-7361
Mailing Address - Country:US
Mailing Address - Phone:626-447-8678
Mailing Address - Fax:626-447-2553
Practice Address - Street 1:550 W DUARTE RD
Practice Address - Street 2:SUITE # 1
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-7331
Practice Address - Country:US
Practice Address - Phone:626-447-8678
Practice Address - Fax:626-447-2553
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42384122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist