Provider Demographics
NPI:1851446447
Name:DELA CRUZ, ALFRED BERNABE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:BERNABE
Last Name:DELA CRUZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22638 CANYON RIDGE PL
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94552-5413
Mailing Address - Country:US
Mailing Address - Phone:510-690-1357
Mailing Address - Fax:
Practice Address - Street 1:18080 SAN RAMON VALLEY BLVD
Practice Address - Street 2:#108
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4437
Practice Address - Country:US
Practice Address - Phone:925-973-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47712122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist