Provider Demographics
NPI:1609933266
Name:EDNA PASQUEL BRAZA DENTAL INC.
Entity Type:Organization
Organization Name:EDNA PASQUEL BRAZA DENTAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:PASQUEL
Authorized Official - Last Name:BRAZA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:805-240-7996
Mailing Address - Street 1:650 HOBSON WAY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-6706
Mailing Address - Country:US
Mailing Address - Phone:805-240-7996
Mailing Address - Fax:805-240-7935
Practice Address - Street 1:650 HOBSON WAY
Practice Address - Street 2:SUITE 101
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-6706
Practice Address - Country:US
Practice Address - Phone:805-240-7996
Practice Address - Fax:805-240-7935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA432281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty