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NPI Code Detail

MEDICARE: RODY PAZ CASANOVA DENTAL INC.

MEDICARE: RODY PAZ CASANOVA DENTAL INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry

General Provider Information

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

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