Provider Demographics
NPI:1184891558
Name:DENNIS S. EGUCHI, DDS, M.S. A DENTAL CORPORATION
Entity type:Organization
Organization Name:DENNIS S. EGUCHI, DDS, M.S. A DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:S
Authorized Official - Last Name:EGUCHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:831-728-0444
Mailing Address - Street 1:390 S GREEN VALLEY RD
Mailing Address - Street 2:SUITE #3
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-3077
Mailing Address - Country:US
Mailing Address - Phone:831-728-0444
Mailing Address - Fax:831-728-0445
Practice Address - Street 1:390 S GREEN VALLEY RD
Practice Address - Street 2:SUITE #3
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-3077
Practice Address - Country:US
Practice Address - Phone:831-728-0444
Practice Address - Fax:831-728-0445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental