Provider Demographics
NPI:1891043667
Name:PEDRO A. ROMERO, D.D.S., INC.
Entity Type:Organization
Organization Name:PEDRO A. ROMERO, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-790-1160
Mailing Address - Street 1:747 FOOTHILL BLVD. SUITE ONE
Mailing Address - Street 2:
Mailing Address - City:LA CANADA FLINTRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91011-3437
Mailing Address - Country:US
Mailing Address - Phone:818-790-1160
Mailing Address - Fax:818-790-5603
Practice Address - Street 1:747 FOOTHILL BLVD. SUITE ONE
Practice Address - Street 2:
Practice Address - City:LA CANADA FLINTRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91011-3437
Practice Address - Country:US
Practice Address - Phone:818-790-1160
Practice Address - Fax:818-790-5603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA505171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty