Provider Demographics
NPI:1104963941
Name:YAMAGUCHI, EUGENE T (DDS)
Entity type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:T
Last Name:YAMAGUCHI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5380 N FRESNO ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-6847
Mailing Address - Country:US
Mailing Address - Phone:559-226-4003
Mailing Address - Fax:559-226-4005
Practice Address - Street 1:5380 N FRESNO ST
Practice Address - Street 2:SUITE 106
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-6847
Practice Address - Country:US
Practice Address - Phone:559-226-4003
Practice Address - Fax:559-226-4005
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0324161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice