Provider Demographics
NPI:1710995709
Name:JULIETA Y ECHEVERRIA DDS INC
Entity Type:Organization
Organization Name:JULIETA Y ECHEVERRIA DDS INC
Other - Org Name:JULIETA Y ECHEVERRIA DDS INC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIETA
Authorized Official - Middle Name:YANIRA
Authorized Official - Last Name:ECHEVERRIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-247-6640
Mailing Address - Street 1:24875 ALESSANDRO BLVD
Mailing Address - Street 2:STE 8
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553
Mailing Address - Country:US
Mailing Address - Phone:951-247-6640
Mailing Address - Fax:951-247-6678
Practice Address - Street 1:24875 ALESSANDRO BLVD
Practice Address - Street 2:STE 8
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553
Practice Address - Country:US
Practice Address - Phone:951-247-6640
Practice Address - Fax:951-247-6678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47073122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty