Provider Demographics
NPI:1306862768
Name:PACIFIC ENDODONTICS, INC.
Entity Type:Organization
Organization Name:PACIFIC ENDODONTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-375-4750
Mailing Address - Street 1:971 PACIFIC ST
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4447
Mailing Address - Country:US
Mailing Address - Phone:831-375-4750
Mailing Address - Fax:831-375-4265
Practice Address - Street 1:971 PACIFIC ST
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4447
Practice Address - Country:US
Practice Address - Phone:831-375-4750
Practice Address - Fax:831-375-4265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty