Provider Demographics
NPI:1497297956
Name:MANUEL PALAU DDS INC
Entity Type:Organization
Organization Name:MANUEL PALAU DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PALAU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-394-2499
Mailing Address - Street 1:800 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:DELANO
Mailing Address - State:CA
Mailing Address - Zip Code:93215-1740
Mailing Address - Country:US
Mailing Address - Phone:661-720-9028
Mailing Address - Fax:
Practice Address - Street 1:800 10TH AVE
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-1740
Practice Address - Country:US
Practice Address - Phone:661-720-9028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63865122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty