Provider Demographics
NPI:1427187483
Name:PINELL, MIGUEL ANGEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:ANGEL
Last Name:PINELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:MIGUEL
Other - Middle Name:A
Other - Last Name:PINELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:3980 SAN PABLO DAM RD
Mailing Address - Street 2:#206
Mailing Address - City:EL SOBRANTE
Mailing Address - State:CA
Mailing Address - Zip Code:94803
Mailing Address - Country:US
Mailing Address - Phone:510-222-3962
Mailing Address - Fax:415-642-2059
Practice Address - Street 1:3980 SAN PABLO DAM RD
Practice Address - Street 2:#206
Practice Address - City:EL SOBRANTE
Practice Address - State:CA
Practice Address - Zip Code:94803
Practice Address - Country:US
Practice Address - Phone:510-222-3962
Practice Address - Fax:415-642-2059
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA371531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice