Organization
HACIENDA DENTAL
Active
Parent organization
EDWARD H. GRUBER DDS
Other names
Edward H Gruber DDS
Organization subpart
Yes
Provider details
NPI number
Legal business name
EDWARD H. GRUBER DDS
Authorized official
MYRNA VELASQUEZ (OFFICE MANAGER)
(661) 871-3736
Entity
Organization
Contact information
Practice address
1507 PANAMA LANE, 102, BAKERSFIELD, CA 93307
(661) 398-5555
(661) 398-5510
Mailing address
4022 NILES ST, BAKERSFIELD, CA 93306-4630
(661) 871-3736
(661) 871-7417
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
33020
CA
Other
Enumeration date
02/09/2009
Last updated
02/09/2009
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