Provider Demographics
NPI:1750528410
Name:JV DENTAL SERVICES
Entity type:Organization
Organization Name:JV DENTAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:VASQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-760-5899
Mailing Address - Street 1:7161 EL CAJON DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-4349
Mailing Address - Country:US
Mailing Address - Phone:915-760-5899
Mailing Address - Fax:
Practice Address - Street 1:AVE. FRANCISCO I. MADERO #60
Practice Address - Street 2:
Practice Address - City:NACO
Practice Address - State:SONORA
Practice Address - Zip Code:84180
Practice Address - Country:MX
Practice Address - Phone:915-727-3118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ4991427261QD0000X
ZZ5046980261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental