Provider Demographics
NPI:1306044987
Name:PARAWAN, FERDINAND LAURON (DDS)
Entity Type:Individual
Prefix:DR
First Name:FERDINAND
Middle Name:LAURON
Last Name:PARAWAN
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 1:21001 SAN RAMON VALLEY BLVD STE C7
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-3456
Mailing Address - Country:US
Mailing Address - Phone:925-829-0994
Mailing Address - Fax:
Practice Address - Street 1:21001 SAN RAMON VALLEY BLVD STE C7
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-3456
Practice Address - Country:US
Practice Address - Phone:925-829-0994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA499691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice