Provider Demographics
NPI:1942648779
Name:RAMOS, PABLO ANDRES (DDS)
Entity Type:Individual
Prefix:
First Name:PABLO
Middle Name:ANDRES
Last Name:RAMOS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:PABLO
Other - Middle Name:ANDRES
Other - Last Name:RAMOS FERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3901 N ROXBORO ST STE 111
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2181
Mailing Address - Country:US
Mailing Address - Phone:919-479-1300
Mailing Address - Fax:
Practice Address - Street 1:3901 N ROXBORO ST STE 111
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2181
Practice Address - Country:US
Practice Address - Phone:919-479-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC95291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice