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Organization
I DENTAL FAMILY DENTISTRY JUAN C HUAMAN DDS,CORP
Active
Organization
I DENTAL FAMILY DENTISTRY JUAN C HUAMAN DDS,CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUAN CARLOS HUAMAN DDS (MANAGING DR)
(559) 673-7700
Entity
Organization
Contact information
Practice address
620 W YOSEMITE AVE, MADERA, CA 93637-4523
(559) 673-7700
(559) 673-7702
Mailing address
620 W YOSEMITE AVE, MADERA, CA 93637-4523
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
59160
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122300000X
GENERAL DENTIST
CA
Enumeration date
02/11/2015
Last updated
02/11/2015
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