Provider Demographics
NPI:1316194368
Name:PADERNA, CARLO MAGNO ARRIBA (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARLO MAGNO
Middle Name:ARRIBA
Last Name:PADERNA
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 1:1627 N KAREN AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-0406
Mailing Address - Country:US
Mailing Address - Phone:732-372-5326
Mailing Address - Fax:
Practice Address - Street 1:1627 N KAREN AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93619-0406
Practice Address - Country:US
Practice Address - Phone:732-372-5326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-21
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA573261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice