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General NPI Number Information
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NPI Number | 1902526866
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Entity Type | Organization
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Legal Business Name | RAYMOND PANDEZ DDS MSD INC
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Dates
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Enumeration Date | 08/31/2022
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Last Update Date | 08/31/2022
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Provider Practice Location Address
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Address Line | 1129 PACIFIC ST
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-3301
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Country | US
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Telephone | 805-541-8731
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Fax |
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Provider Business Mailing Address
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Address Line | 1629 FOXWORTHY AVE
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City | SAN JOSE
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State | CA
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Zip | 95118-1008
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAYMOND PANDEZ
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Credential | DDS
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Telephone | 408-891-0399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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