Provider Demographics
NPI:1194244566
Name:PARTIDA, HUGO J (DDS)
Entity type:Individual
Prefix:
First Name:HUGO
Middle Name:J
Last Name:PARTIDA
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 1:23407 MOUNTAIN SONG LOOP
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5011
Mailing Address - Country:US
Mailing Address - Phone:858-568-4266
Mailing Address - Fax:
Practice Address - Street 1:25395 MADISON AVE STE 103
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-9003
Practice Address - Country:US
Practice Address - Phone:951-239-3597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-16
Last Update Date:2017-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101885122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist