Provider Demographics
NPI:1083810964
Name:PASKO, JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:PASKO
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 1:2 OSBORN ST
Mailing Address - Street 2:SUITE 140
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4690
Mailing Address - Country:US
Mailing Address - Phone:949-857-2004
Mailing Address - Fax:949-857-2079
Practice Address - Street 1:2 OSBORN ST
Practice Address - Street 2:SUITE 140
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4690
Practice Address - Country:US
Practice Address - Phone:949-857-2004
Practice Address - Fax:949-857-2079
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice