Provider Demographics
NPI:1851884373
Name:JULIO E CACERES DDS, INC
Entity Type:Organization
Organization Name:JULIO E CACERES DDS, INC
Other - Org Name:DENTAL PARADISE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:
Authorized Official - Last Name:CACERES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-914-1887
Mailing Address - Street 1:1104 W 17TH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706-3506
Mailing Address - Country:US
Mailing Address - Phone:714-914-1887
Mailing Address - Fax:
Practice Address - Street 1:1104 W 17TH ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-3506
Practice Address - Country:US
Practice Address - Phone:714-914-1887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JULIO E CACERES DDS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-09
Last Update Date:2018-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental