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General NPI Number Information
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NPI Number | 1841203502
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Entity Type | Individual
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Provider Name | VERONICA A CERVANTES-PRADO DDS
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Gender | Female
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 08/21/2023
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Provider Practice Location Address
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Address Line | 175 W COURT ST
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City | WOODLAND
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State | CA
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Zip | 95695-2913
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Country | US
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Telephone | 530-661-4430
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9067
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City | VALLEJO
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State | CA
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Zip | 94591-9067
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Country | US
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Telephone | 707-557-5822
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 54300
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License Number State | CA
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