Provider Demographics
NPI:1780024315
Name:SOTO, ANNETTY PAMELA
Entity Type:Individual
Prefix:DR
First Name:ANNETTY
Middle Name:PAMELA
Last Name:SOTO
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:ANNETTY
Other - Middle Name:PAMELA
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:8210 FLOYD CURL DR RM 1162.01
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3923
Mailing Address - Country:US
Mailing Address - Phone:104-503-2932
Mailing Address - Fax:
Practice Address - Street 1:8210 FLOYD CURL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3923
Practice Address - Country:US
Practice Address - Phone:210-450-3290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39185122300000X
FLDTP652122300000X
MADL11911122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist