Provider Demographics
NPI:1891940664
Name:PASCUA, HOFFNER JAVATE (DDS)
Entity Type:Individual
Prefix:DR
First Name:HOFFNER
Middle Name:JAVATE
Last Name:PASCUA
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 1:15725 POMERADO RD STE 110
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-2058
Mailing Address - Country:US
Mailing Address - Phone:858-485-6900
Mailing Address - Fax:858-485-5875
Practice Address - Street 1:15725 POMERADO RD STE 110
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2058
Practice Address - Country:US
Practice Address - Phone:858-485-6900
Practice Address - Fax:858-485-5875
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA554811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice