Provider Demographics
NPI:1871634493
Name:ROMERO, PEDRO A (DDS)
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:A
Last Name:ROMERO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24137 WILLOWBROOKE CT
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91354-4937
Mailing Address - Country:US
Mailing Address - Phone:661-799-2881
Mailing Address - Fax:
Practice Address - Street 1:811 S ALVARADO ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-4009
Practice Address - Country:US
Practice Address - Phone:213-383-3114
Practice Address - Fax:213-383-0621
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA505171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice