Provider Demographics
NPI:1720645708
Name:PELEHAC, ANGELA M (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:M
Last Name:PELEHAC
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 1:4310 DUNLAVY ST APT 410
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-5313
Mailing Address - Country:US
Mailing Address - Phone:724-880-7233
Mailing Address - Fax:
Practice Address - Street 1:4310 DUNLAVY ST APT 410
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-5313
Practice Address - Country:US
Practice Address - Phone:724-880-7233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-24
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1002060151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice