Provider Demographics
NPI:1902020977
Name:PACHECO, ROBERTO AUGUSTO (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:AUGUSTO
Last Name:PACHECO
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 1:2323 DE LA VINA ST
Mailing Address - Street 2:SUITE # 207
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-3877
Mailing Address - Country:US
Mailing Address - Phone:805-687-1106
Mailing Address - Fax:805-687-5886
Practice Address - Street 1:2323 DE LA VINA ST
Practice Address - Street 2:SUITE # 207
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3877
Practice Address - Country:US
Practice Address - Phone:805-687-1106
Practice Address - Fax:805-687-5886
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38725122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist