Organization Name: | HERNANDEZ & BUCK, A DENTAL PARTNERSHIP |
NPI Number: | 1659779734 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STEVEN D HERNANDEZ (OWNER/PARTNER) |
Mailing Address: | 9560 Baseline Rd Suite B Alta Loma |
State: | CA US |
Postal Code: | 917016435 |
Phone Number: | 9099877676 |
Fax Number: | 9099489413 |
NPI Enumeration Date: | 12/05/2014 |
NPI Last Update Date: | 12/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |