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General NPI Number Information
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NPI Number | 1497327787
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Entity Type | Organization
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Legal Business Name | SVAGO DENTAL PRACTICE INC
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Dates
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Enumeration Date | 07/15/2021
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Last Update Date | 07/15/2021
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Provider Practice Location Address
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Address Line | 200 E DEL MAR BLVD STE 100
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City | PASADENA
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State | CA
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Zip | 91105-2565
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Country | US
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Telephone | 626-792-6344
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Fax | 626-765-9913
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Provider Business Mailing Address
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Address Line | 200 E DEL MAR BLVD STE 100
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City | PASADENA
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State | CA
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Zip | 91105-2565
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Country | US
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Telephone | 626-792-6344
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Fax | 626-765-9913
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Authorized Official
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Title or Position | OWNER
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Name | ALEJANDRO ECHEVERRY
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Credential | DDS
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Telephone | 626-792-6344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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