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Organization
SEGUY & HERNANDEZ, A DENTAL PART.
Active
Organization
SEGUY & HERNANDEZ, A DENTAL PART.
Active
Other names
Baseline Dental Practice
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN HERNANDEZ D.D.S. (PRESIDENT)
(909) 987-7676
Entity
Organization
Contact information
Practice address
9560 BASELINE RD, SUITE B, ALTA LOMA, CA 91701-6435
(909) 987-7676
(909) 948-9413
Mailing address
9560 BASELINE RD, SUITE B, ALTA LOMA, CA 91701-6435
(909) 987-7676
(909) 948-9413
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
26528
CA
122300000X
Dentist
37836
CA
122300000X
Dentist
55916
CA
122300000X
Dentist
Primary
FNP 5936
CA
1223P0300X
Periodontics
46081
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
36457
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41104381
EDD
CA
Enumeration date
05/20/2006
Last updated
07/20/2007
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