Provider Demographics
NPI:1972874519
Name:HURTADO, CESAR F JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:CESAR
Middle Name:F
Last Name:HURTADO
Suffix:JR
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 1:9463 W FLAGLER ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2010
Mailing Address - Country:US
Mailing Address - Phone:305-444-1555
Mailing Address - Fax:305-226-7669
Practice Address - Street 1:9463 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2010
Practice Address - Country:US
Practice Address - Phone:305-444-1555
Practice Address - Fax:305-226-7669
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-12
Last Update Date:2012-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10614122300000X
FLDN 20027122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist