Individual
DR. LARRY E. FUKUMOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
5631 LINCOLN AVE, CYPRESS, CA 90630-3156
(714) 995-2040
(714) 995-2081
Mailing address
5631 LINCOLN AVE, CYPRESS, CA 90630-3156
(714) 995-2040
(714) 995-2081
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
18832
CA
Other
Enumeration date
08/17/2006
Last updated
07/08/2007
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