Provider Demographics
NPI:1144348442
Name:SUGITA, EUGENE ISAMU (DDS)
Entity type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:ISAMU
Last Name:SUGITA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8860 CENTER DR STE 430
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-7001
Mailing Address - Country:US
Mailing Address - Phone:619-713-6600
Mailing Address - Fax:619-713-6644
Practice Address - Street 1:8860 CENTER DR STE 430
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-7001
Practice Address - Country:US
Practice Address - Phone:619-713-6600
Practice Address - Fax:619-713-6644
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0317141223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics