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General NPI Number Information
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NPI Number | 1932329356
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Entity Type | Individual
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Provider Name | RONALD A PAEZ DDS
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Gender | Male
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6011 PACIFIC BLVD SUITE # 120
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-2951
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Country | US
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Telephone | 323-584-6777
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Fax | 323-583-2370
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Provider Business Mailing Address
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Address Line | 8328 BEECHTREE WAY
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City | PANORAMA CITY
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State | CA
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Zip | 91402-4038
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Country | US
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Telephone | 818-908-4207
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | D-41506
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License Number State | CA
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