Provider Demographics
NPI:1386077154
Name:SONRISAS DENTALES
Entity type:Organization
Organization Name:SONRISAS DENTALES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:MATIAS
Authorized Official - Last Name:HOYOS
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:805-379-3336
Mailing Address - Street 1:398 LOMBARD ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-8226
Mailing Address - Country:US
Mailing Address - Phone:805-379-3336
Mailing Address - Fax:805-379-0122
Practice Address - Street 1:398 LOMBARD ST
Practice Address - Street 2:SUITE A
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-8226
Practice Address - Country:US
Practice Address - Phone:805-379-3336
Practice Address - Fax:805-379-0122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-15
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental