Provider Demographics
NPI:1518309707
Name:MARIA LUCIA CRUZ, D.D.S., INC.
Entity Type:Organization
Organization Name:MARIA LUCIA CRUZ, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA LUCIA
Authorized Official - Middle Name:AQUINO
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-642-3977
Mailing Address - Street 1:11509 BURBANK BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-2309
Mailing Address - Country:US
Mailing Address - Phone:818-753-4800
Mailing Address - Fax:
Practice Address - Street 1:11509 BURBANK BLVD
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-2309
Practice Address - Country:US
Practice Address - Phone:818-753-4800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-29
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental