Provider Demographics
NPI:1942534268
Name:PELL, VERONICA (DDS)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:
Last Name:PELL
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:PO BOX 1802
Mailing Address - Street 2:
Mailing Address - City:DONNA
Mailing Address - State:TX
Mailing Address - Zip Code:78537-1802
Mailing Address - Country:US
Mailing Address - Phone:956-975-1838
Mailing Address - Fax:
Practice Address - Street 1:COAHUILA #25 LOCAL 1A
Practice Address - Street 2:
Practice Address - City:NUEVO PROGRESO
Practice Address - State:TAMAULIPAS
Practice Address - Zip Code:88810
Practice Address - Country:MX
Practice Address - Phone:956-373-1568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ31629661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice