Provider Demographics
NPI:1003116278
Name:MAJOR, PAKO M (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAKO
Middle Name:M
Last Name:MAJOR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2116 VISTA OESTE NW STE 202
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-4341
Mailing Address - Country:US
Mailing Address - Phone:414-699-5506
Mailing Address - Fax:
Practice Address - Street 1:N168W20060 MAIN ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:WI
Practice Address - Zip Code:53037-9380
Practice Address - Country:US
Practice Address - Phone:262-677-3003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD3443122300000X
WI6616-151223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice