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Organization
GUTIERREZ, VICENCIO, DOMINGUEZ DDS INC
Active
Organization
GUTIERREZ, VICENCIO, DOMINGUEZ DDS INC
Active
Other names
Santa Ana Magic Smile
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA L. GUTIERREZ DDS (PRESIDENT)
(714) 835-6677
Entity
Organization
Contact information
Practice address
2112 N MAIN ST, SUITE # 100, SANTA ANA, CA 92706-2739
(714) 835-6677
(714) 558-6892
Mailing address
2112 N MAIN ST, SUITE # 100, SANTA ANA, CA 92706-2739
(714) 835-6677
(714) 558-6892
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D44176
CA
Other
Enumeration date
09/22/2007
Last updated
09/22/2007
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