Individual
EUGENE HUMPHRIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
18000 PIONEER BLVD STE 207, ARTESIA, CA 90701-4416
(562) 860-1333
Mailing address
18000 PIONEER BLVD STE 207, ARTESIA, CA 90701-4416
(562) 860-1333
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
21371
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B21371-01
DENTI-CAL PROVIDER ID #
CA
Enumeration date
10/10/2006
Last updated
07/08/2007
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