Provider Demographics
NPI:1891967766
Name:RODRIGUEZ-PUGEDA, PAULYN CONNOR (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAULYN
Middle Name:CONNOR
Last Name:RODRIGUEZ-PUGEDA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2370 MARITIME DR
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-3639
Mailing Address - Country:US
Mailing Address - Phone:916-446-7768
Mailing Address - Fax:916-446-9014
Practice Address - Street 1:2370 MARITIME DR
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-3639
Practice Address - Country:US
Practice Address - Phone:916-446-7768
Practice Address - Fax:916-446-9014
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA567811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice