Basic Information
| Provider Information | |||||||||
| NPI: | 1811265879 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CORTES | ||||||||
| FirstName: | DIANA | ||||||||
| MiddleName: | PALOMA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5369 S CALLE SANTA CRUZ | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857063963 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5208893379 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5369 S CALLE SANTA CRUZ | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857063963 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5208893379 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2011 | ||||||||
| LastUpdateDate: | 10/03/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | D009570 | AZ | Y | Dental Providers | Dentist |
No ID Information.