Provider Demographics
NPI:1386711620
Name:PARY, MARIO (DMD)
Entity type:Individual
Prefix:
First Name:MARIO
Middle Name:
Last Name:PARY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16691 YORBA LINDA BLVD
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-2046
Mailing Address - Country:US
Mailing Address - Phone:714-854-9920
Mailing Address - Fax:714-854-9915
Practice Address - Street 1:16691 YORBA LINDA BLVD
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-2046
Practice Address - Country:US
Practice Address - Phone:714-854-9920
Practice Address - Fax:714-854-9915
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA534751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice