Provider Demographics
NPI:1760678650
Name:LUCIANE QUEIROZ DDS INC
Entity Type:Organization
Organization Name:LUCIANE QUEIROZ DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUCIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:QUEIROZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:661-833-0707
Mailing Address - Street 1:2160 WHITE LN
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93304-6915
Mailing Address - Country:US
Mailing Address - Phone:661-833-0707
Mailing Address - Fax:661-833-0808
Practice Address - Street 1:2160 WHITE LN
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-6915
Practice Address - Country:US
Practice Address - Phone:661-833-0707
Practice Address - Fax:661-833-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA526741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty