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General NPI Number Information
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NPI Number | 1831661586
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Entity Type | Organization
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Legal Business Name | RODY PAZ CASANOVA DENTAL INC.
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Dates
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Enumeration Date | 12/19/2018
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Last Update Date | 06/09/2020
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Provider Practice Location Address
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Address Line | 1655 S WESTERN AVE STE C
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City | LOS ANGELES
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State | CA
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Zip | 90006-5801
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Country | US
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Telephone | 323-529-0002
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Fax |
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Provider Business Mailing Address
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Address Line | 10728 RAMONA BLVD STE D
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City | EL MONTE
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State | CA
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Zip | 91731-2601
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Country | US
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Telephone | 626-416-5500
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | RODY PAZ CASANOVA
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Credential |
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Telephone | 626-416-5500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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