| Alcira Urrutia Dds Professional Corporation | |
|
1160 N Maclay Ave Suite # 107 San Fernando CA 91340-5127 | |
| (818) 714-7714 | |
| Not Available |
| Full Name | Alcira Urrutia Dds Professional Corporation |
|---|---|
| Speciality | Dentist |
| Location | 1160 N Maclay Ave, San Fernando, California |
| Authorized Official Name and Position | Alcira M Urrutia (DENTIST/OWNER) |
| Authorized Official Contact | 8187147714 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alcira Urrutia Dds Professional Corporation 1160 N Maclay Ave Suite # 107 San Fernando CA 91340-5127 Ph: (818) 714-7714 | Alcira Urrutia Dds Professional Corporation 1160 N Maclay Ave Suite # 107 San Fernando CA 91340-5127 Ph: (818) 714-7714 |
| NPI Number | 1033485685 |
|---|---|
| Provider Enumeration Date | 03/28/2012 |
| Last Update Date | 03/28/2012 |
| Medicare PECOS PAC ID | 9537522941 |
|---|---|
| Medicare Enrollment ID | O20230901001947 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033485685 | NPI | - | NPPES |
| D55679 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 55679 (California) | Primary |
| Provider Name | Alcira M Urrutia |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1326236290 PECOS PAC ID: 0446613855 Enrollment ID: I20230901001976 |
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