Provider Demographics
NPI:1013209063
Name:CORTEZ PACHECO, NORMA EVELYN (DDS)
Entity Type:Individual
Prefix:DR
First Name:NORMA
Middle Name:EVELYN
Last Name:CORTEZ PACHECO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 E VERDUGO AVE APT 101
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91501-3118
Mailing Address - Country:US
Mailing Address - Phone:818-802-2729
Mailing Address - Fax:
Practice Address - Street 1:1330 S VERMONT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-4502
Practice Address - Country:US
Practice Address - Phone:818-802-2729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-10
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60288122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist