Provider Demographics
NPI:1831196229
Name:CATURAY, PEDRO A (DDS)
Entity type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:A
Last Name:CATURAY
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 1:1301 BROADWAY AVE
Mailing Address - Street 2:STE 7
Mailing Address - City:MILLBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94030
Mailing Address - Country:US
Mailing Address - Phone:650-589-3667
Mailing Address - Fax:650-589-3663
Practice Address - Street 1:1301 BROADWAY
Practice Address - Street 2:STE 7
Practice Address - City:MILLBRAE
Practice Address - State:CA
Practice Address - Zip Code:94030-1336
Practice Address - Country:US
Practice Address - Phone:650-589-3667
Practice Address - Fax:650-589-3675
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2014-01-15
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-05-06
Provider Licenses
StateLicense IDTaxonomies
CA39609122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist