Individual
EDUARDO VASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
501 S IDAHO ST, SUITE 120, LA HABRA, CA 90631-6047
(562) 690-0400
Mailing address
12859 PALM ST, GARDEN GROVE, CA 92840-6401
(714) 534-1237
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
49825
CA
1223D0001X
Public Health Dentistry
49825
CA
1223G0001X
General Practice Dentistry
49825
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366584146
—
CA
Enumeration date
02/12/2007
Last updated
06/01/2021
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