Provider Demographics
NPI:1770862518
Name:DEL RIO, PAULINA JANETTE (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAULINA
Middle Name:JANETTE
Last Name:DEL RIO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27724 BRUNO ST
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-5259
Mailing Address - Country:US
Mailing Address - Phone:510-847-7594
Mailing Address - Fax:
Practice Address - Street 1:27724 BRUNO ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-5259
Practice Address - Country:US
Practice Address - Phone:510-847-7594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60319122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist