Provider Demographics
NPI:1033554787
Name:DENTAL CORPORATION OF R. PAZ, DDS., INC
Entity type:Organization
Organization Name:DENTAL CORPORATION OF R. PAZ, DDS., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/
Authorized Official - Prefix:
Authorized Official - First Name:RODY
Authorized Official - Middle Name:
Authorized Official - Last Name:PAZ-CASANOVA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-962-8160
Mailing Address - Street 1:14323 RAMONA BLVD
Mailing Address - Street 2:
Mailing Address - City:BALDWIN PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91706-3242
Mailing Address - Country:US
Mailing Address - Phone:626-962-8160
Mailing Address - Fax:626-962-8170
Practice Address - Street 1:14323 RAMONA BLVD
Practice Address - Street 2:
Practice Address - City:BALDWIN PARK
Practice Address - State:CA
Practice Address - Zip Code:91706-3242
Practice Address - Country:US
Practice Address - Phone:626-962-8160
Practice Address - Fax:626-962-8170
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DENTAL CORPORATION OF R. PAZ, DDS., INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty