Provider Demographics
NPI:1568583672
Name:TERRA, JULIO ULISES (DDS)
Entity Type:Individual
Prefix:DR
First Name:JULIO
Middle Name:ULISES
Last Name:TERRA
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 1:5220 E LOS ALTOS PLZ
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-4251
Mailing Address - Country:US
Mailing Address - Phone:562-968-9995
Mailing Address - Fax:562-698-1376
Practice Address - Street 1:5220 E LOS ALTOS PLZ
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-4251
Practice Address - Country:US
Practice Address - Phone:562-968-9995
Practice Address - Fax:562-698-1376
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA496831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice