Provider Demographics
NPI:1336200237
Name:FRANCO, PACITA DIONISIO (DDS)
Entity type:Individual
Prefix:DR
First Name:PACITA
Middle Name:DIONISIO
Last Name:FRANCO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 N ALLEN AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-1604
Mailing Address - Country:US
Mailing Address - Phone:626-795-6566
Mailing Address - Fax:888-384-5945
Practice Address - Street 1:324 N ALLEN AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-1604
Practice Address - Country:US
Practice Address - Phone:626-795-6566
Practice Address - Fax:888-384-5945
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA402271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB40227-03Medicaid
CA889370OtherUNITED CONCORDIA
CAZQB540OtherBCBS OF MASSACHUSETTES