Organization
EUGENE HUMPHRIES, D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA CANDACE FUNDERBURK (DENTAL CONSULTANT)
(714) 716-6244
Entity
Organization
Contact information
Practice address
27981 GREENFIELD DR STE F, LAGUNA NIGUEL, CA 92677-1494
(949) 362-7474
(949) 362-0470
Mailing address
27981 GREENFIELD DR STE F, LAGUNA NIGUEL, CA 92677-1494
(949) 362-7474
(949) 362-0470
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
21371
CA
Other
Enumeration date
10/18/2006
Last updated
04/16/2008
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