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Organization

ALCIRA URRUTIA DDS PROFESSIONAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALCIRA M URRUTIA D.D.S. (DENTIST/OWNER)
(818) 714-7714
Entity
Organization

Contact information

Practice address
1160 N MACLAY AVE, SUITE # 107, SAN FERNANDO, CA 91340-5127
(818) 714-7714
Mailing address
1160 N MACLAY AVE, SUITE # 107, SAN FERNANDO, CA 91340-5127
(818) 714-7714

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
55679
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
D55679
CA
Enumeration date
03/28/2012
Last updated
03/28/2012
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