Gutierrez, Vicencio, Dominguez DDS INC
Clinic/Center, Dental in Santa Ana, CA. Organization (NPI-2).
NPI number1386830438
StatusActive
Last updated in NPPESSep 22, 2007
Details
- NPI
- 1386830438
- Entity type
- Organization (NPI-2)
- Legal business name
- Gutierrez, Vicencio, Dominguez DDS INC
- Organization subpart
- No
- Enumeration date
- Sep 22, 2007
- Last updated
- Sep 22, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | D44176 | CA | Yes |
Other names
- Santa Ana Magic Smile (Doing Business As)
Practice location
2112 N Main StSuite # 100
Santa Ana, CA 92706-2739
Phone 714-835-6677 · Fax 714-558-6892
Mailing address
2112 N Main StSuite # 100
Santa Ana, CA 92706-2739
Phone 714-835-6677 · Fax 714-558-6892
Authorized official
Martha L. Gutierrez
President
7148356677
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