Provider Demographics
NPI:1972653103
Name:PECAN DENTAL, P. A.
Entity type:Organization
Organization Name:PECAN DENTAL, P. A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:W
Authorized Official - Last Name:PAPARELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:956-330-6181
Mailing Address - Street 1:710 S CAGE BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-5446
Mailing Address - Country:US
Mailing Address - Phone:956-283-1861
Mailing Address - Fax:
Practice Address - Street 1:710 S CAGE BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-5446
Practice Address - Country:US
Practice Address - Phone:956-283-1861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty