Provider Demographics
NPI:1679690721
Name:MAURICIO CARDENAS DDS INC
Entity Type:Organization
Organization Name:MAURICIO CARDENAS DDS INC
Other - Org Name:MC COSMETIC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PRESIDENT DDS
Authorized Official - Prefix:MR
Authorized Official - First Name:MAURICIO
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:CARDENAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-830-2003
Mailing Address - Street 1:26720 TOWNE CENTRE DR
Mailing Address - Street 2:SUITE #B
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610
Mailing Address - Country:US
Mailing Address - Phone:949-830-2003
Mailing Address - Fax:949-830-2017
Practice Address - Street 1:26720 TOWNE CENTRE DR
Practice Address - Street 2:SUITE #B MC COSMETIC DENTISTRY
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610
Practice Address - Country:US
Practice Address - Phone:949-830-2003
Practice Address - Fax:949-830-2017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43326122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty