Provider Demographics
NPI:1174659643
Name:CANDELARIA, CATHERINE PASCUAL (DDS)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:PASCUAL
Last Name:CANDELARIA
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 1:321 RARITAN AVENUE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-2701
Mailing Address - Country:US
Mailing Address - Phone:732-296-1144
Mailing Address - Fax:732-296-0990
Practice Address - Street 1:321 RARITAN AVENUE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-2701
Practice Address - Country:US
Practice Address - Phone:732-296-1144
Practice Address - Fax:732-296-0990
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI195221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice