Provider Demographics
NPI:1558774109
Name:LORENZO M PADRON & ANGEL J PINTO DDS & CORPORATION
Entity type:Organization
Organization Name:LORENZO M PADRON & ANGEL J PINTO DDS & CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:PINTO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:831-207-3224
Mailing Address - Street 1:680 MARSEILLE DR
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-7163
Mailing Address - Country:US
Mailing Address - Phone:831-207-5072
Mailing Address - Fax:
Practice Address - Street 1:925 SECRET RIVER DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-3465
Practice Address - Country:US
Practice Address - Phone:831-207-5072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-10
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA521031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty