Provider Demographics
NPI:1942444518
Name:MUROTANI, HIROSHI (DDS)
Entity Type:Individual
Prefix:DR
First Name:HIROSHI
Middle Name:
Last Name:MUROTANI
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 1:3620 S BRISTOL ST
Mailing Address - Street 2:SUITE 209
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-7300
Mailing Address - Country:US
Mailing Address - Phone:714-641-0681
Mailing Address - Fax:714-641-8785
Practice Address - Street 1:3620 S BRISTOL ST
Practice Address - Street 2:SUITE 209
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-7300
Practice Address - Country:US
Practice Address - Phone:714-641-0681
Practice Address - Fax:714-641-8785
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-28
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32493122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist