Provider Demographics
NPI:1376856690
Name:PASIERB, CANA EDWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:CANA
Middle Name:EDWARD
Last Name:PASIERB
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 1:3700 MARKET ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-3147
Mailing Address - Country:US
Mailing Address - Phone:215-387-0883
Mailing Address - Fax:215-387-9659
Practice Address - Street 1:3700 MARKET ST
Practice Address - Street 2:SUITE 101
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3147
Practice Address - Country:US
Practice Address - Phone:215-387-0883
Practice Address - Fax:215-387-9659
Is Sole Proprietor?:No
Enumeration Date:2010-07-15
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0390221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADS0309022OtherPA DENTAL LICENSE