Provider Demographics
NPI:1427807940
Name:DRPALIDENTAL INC.
Entity type:Organization
Organization Name:DRPALIDENTAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENCIA HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-459-2721
Mailing Address - Street 1:910 VIA DE LA PAZ STE 204
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-3545
Mailing Address - Country:US
Mailing Address - Phone:310-459-2721
Mailing Address - Fax:310-230-3623
Practice Address - Street 1:910 VIA DE LA PAZ STE 204
Practice Address - Street 2:
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-3545
Practice Address - Country:US
Practice Address - Phone:310-459-2721
Practice Address - Fax:310-230-3623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty