Provider Demographics
NPI:1831661586
Name:RODY PAZ CASANOVA DENTAL INC.
Entity Type:Organization
Organization Name:RODY PAZ CASANOVA DENTAL INC.
Other - Org Name:HAPPY SMILES
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RODY
Authorized Official - Middle Name:
Authorized Official - Last Name:PAZ CASANOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-416-5500
Mailing Address - Street 1:10728 RAMONA BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-2601
Mailing Address - Country:US
Mailing Address - Phone:626-416-5500
Mailing Address - Fax:
Practice Address - Street 1:1655 S WESTERN AVE STE C
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-5801
Practice Address - Country:US
Practice Address - Phone:323-529-0002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-19
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty