Provider Demographics
NPI:1811696214
Name:CESAR A ECHEVERRY DDS CORP
Entity type:Organization
Organization Name:CESAR A ECHEVERRY DDS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:AUGUSTO
Authorized Official - Last Name:ECHEVERRY
Authorized Official - Suffix:SR
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-309-6878
Mailing Address - Street 1:728 W 19TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-6148
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:728 W 19TH ST STE B
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-6148
Practice Address - Country:US
Practice Address - Phone:703-309-6878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental