Provider Demographics
NPI:1215128624
Name:VIRGILIO C CORTEZ DMD INC
Entity type:Organization
Organization Name:VIRGILIO C CORTEZ DMD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:VIRGILIO
Authorized Official - Middle Name:CARICUNGAN
Authorized Official - Last Name:CORTEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:408-260-8500
Mailing Address - Street 1:885 SCOTT BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:STA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050
Mailing Address - Country:US
Mailing Address - Phone:408-260-8500
Mailing Address - Fax:408-260-8300
Practice Address - Street 1:885 SCOTT BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:STA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050
Practice Address - Country:US
Practice Address - Phone:408-260-8500
Practice Address - Fax:408-260-8300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45846122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty