Provider Demographics
NPI:1528025798
Name:SUAREZ AYORA, HERNANDO (DDS)
Entity Type:Individual
Prefix:
First Name:HERNANDO
Middle Name:
Last Name:SUAREZ AYORA
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 1:2280 S GAREY AVE
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-5645
Mailing Address - Country:US
Mailing Address - Phone:909-364-0633
Mailing Address - Fax:
Practice Address - Street 1:2280 S GAREY AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-5645
Practice Address - Country:US
Practice Address - Phone:909-364-0633
Practice Address - Fax:714-537-7755
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48384122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist