Provider Demographics
NPI:1891706297
Name:DELA CRUZ, BEN TOLENTINO JR (DMD INC)
Entity Type:Individual
Prefix:DR
First Name:BEN
Middle Name:TOLENTINO
Last Name:DELA CRUZ
Suffix:JR
Gender:M
Credentials:DMD INC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1875 S CENTRE CITY PKWY
Mailing Address - Street 2:SUITE #C
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025
Mailing Address - Country:US
Mailing Address - Phone:760-737-8100
Mailing Address - Fax:760-737-8188
Practice Address - Street 1:1875 S CENTRE CITY PKWY
Practice Address - Street 2:SUITE #C
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025
Practice Address - Country:US
Practice Address - Phone:760-737-8100
Practice Address - Fax:760-737-8188
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA49088122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist