Provider Demographics
NPI:1194997478
Name:EGUCHI, DENNIS SHO (DDS)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:SHO
Last Name:EGUCHI
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 1:361 ARBOL DR
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-2758
Mailing Address - Country:US
Mailing Address - Phone:831-761-2556
Mailing Address - Fax:
Practice Address - Street 1:390 S GREEN VALLEY RD
Practice Address - Street 2:SUITE #3
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-3077
Practice Address - Country:US
Practice Address - Phone:831-728-0444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA0276051223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics