Provider Demographics
NPI:1447640776
Name:MARIA ANA CANUTO DDS INC
Entity type:Organization
Organization Name:MARIA ANA CANUTO DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CANUTO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-713-7751
Mailing Address - Street 1:36612 NEWARK BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-3037
Mailing Address - Country:US
Mailing Address - Phone:510-713-7751
Mailing Address - Fax:510-894-2594
Practice Address - Street 1:36612 NEWARK BLVD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-3037
Practice Address - Country:US
Practice Address - Phone:510-713-7751
Practice Address - Fax:510-894-2594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48239261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental