Provider Demographics
NPI:1962521302
Name:HIURA, DIANE M (DDS)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:M
Last Name:HIURA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:M
Other - Last Name:HIURA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:500 SPRUCE ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118
Mailing Address - Country:US
Mailing Address - Phone:415-752-5244
Mailing Address - Fax:415-752-6736
Practice Address - Street 1:500 SPRUCE ST
Practice Address - Street 2:SUITE 203
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118
Practice Address - Country:US
Practice Address - Phone:415-752-5244
Practice Address - Fax:415-752-6736
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31799122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist