Provider Demographics
NPI:1770736738
Name:CYPRESS PLAZA DENTAL GROUP
Entity type:Organization
Organization Name:CYPRESS PLAZA DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST,OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:BADEA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-226-9630
Mailing Address - Street 1:5460 ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-3740
Mailing Address - Country:US
Mailing Address - Phone:714-226-9630
Mailing Address - Fax:714-226-0190
Practice Address - Street 1:5460 ORANGE AVE
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-3740
Practice Address - Country:US
Practice Address - Phone:714-226-9630
Practice Address - Fax:714-226-0190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-03
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA362221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty