National Provider Identifier Database

EL PASO PELLICANO FAMILY DENTISTRY
Dental


Contact Information

EL PASO PELLICANO FAMILY DENTISTRY
11615 PELLICANO DR STE 100
EL PASO, TX79936-6242
Phone: 915-444-8006
Fax:
Website:
Specialty Taxonomy Code
* Dental 261QD0000X
Oral Medicinist 125Q00000X

* Indicates primary specialty

NPI Profile & details for EL PASO PELLICANO FAMILY DENTISTRY

NPI Number 1629663356
Legal business name
LBN
EL PASO PELLICANO FAMILY DENTISTRY
Authorized official JASVINDER BADWALZ - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 03/04/2021
Last updated 07/26/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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