Provider Demographics
NPI:1033523204
Name:PAZMINO, MANUEL JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:
Last Name:PAZMINO
Suffix:JR
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 1:3013 SCOTT BLVD
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-6815
Mailing Address - Country:US
Mailing Address - Phone:254-778-3587
Mailing Address - Fax:
Practice Address - Street 1:3013 SCOTT BLVD
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-6815
Practice Address - Country:US
Practice Address - Phone:254-778-3587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-16
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX301191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice