Provider Demographics
NPI:1891904835
Name:ERICK N CUENCA DMD INC
Entity Type:Organization
Organization Name:ERICK N CUENCA DMD INC
Other - Org Name:BELMONT DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERICK
Authorized Official - Middle Name:N
Authorized Official - Last Name:CUENCA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:650-593-5110
Mailing Address - Street 1:570 MASONIC WAY
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94002-2703
Mailing Address - Country:US
Mailing Address - Phone:650-593-5110
Mailing Address - Fax:
Practice Address - Street 1:570 MASONIC WAY
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:CA
Practice Address - Zip Code:94002-2703
Practice Address - Country:US
Practice Address - Phone:650-593-5110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty