Provider Demographics
NPI:1619687928
Name:TRUDENTAL CARE INC
Entity Type:Organization
Organization Name:TRUDENTAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:DR
Authorized Official - First Name:MILAGROS
Authorized Official - Middle Name:JAVIER
Authorized Official - Last Name:MACARAIG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:900-577-1222
Mailing Address - Street 1:15586 7TH ST
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-3224
Mailing Address - Country:US
Mailing Address - Phone:909-577-1222
Mailing Address - Fax:
Practice Address - Street 1:15586 7TH ST
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-3224
Practice Address - Country:US
Practice Address - Phone:909-577-1222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental