Provider Demographics
NPI:1689825804
Name:FRANCE, GARY LEWIS
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:LEWIS
Last Name:FRANCE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:GARY
Other - Middle Name:LEWIS
Other - Last Name:FRANCE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:3272 SKYVIEW RIDGE
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709
Mailing Address - Country:US
Mailing Address - Phone:951-756-8729
Mailing Address - Fax:
Practice Address - Street 1:3272 SKYVIEW RDG
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-3541
Practice Address - Country:US
Practice Address - Phone:951-756-8729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39732122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist