Provider Demographics
NPI:1427373620
Name:DANIEL A. PONCE, D.D.S., INC.
Entity Type:Organization
Organization Name:DANIEL A. PONCE, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:PONCE
Authorized Official - Suffix:
Authorized Official - Credentials:D,D,S,
Authorized Official - Phone:650-321-6448
Mailing Address - Street 1:750 WELCH RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1507
Mailing Address - Country:US
Mailing Address - Phone:650-321-6448
Mailing Address - Fax:650-321-5277
Practice Address - Street 1:750 WELCH RD
Practice Address - Street 2:SUITE 102
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1507
Practice Address - Country:US
Practice Address - Phone:650-321-6448
Practice Address - Fax:650-321-5277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-30
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA549491223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty