Provider Demographics
NPI:1790053023
Name:DR. JOHN R. PASQUAL D.M.D., P.A.
Entity Type:Organization
Organization Name:DR. JOHN R. PASQUAL D.M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:PASQUAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-900-9080
Mailing Address - Street 1:4600 LINTON BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-6600
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4600 LINTON BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-6600
Practice Address - Country:US
Practice Address - Phone:561-900-9080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty