Pacheco, Ivan F
Pacheco, Ivan F is an individual health care provider with primary practice located at 167 North Main Street , Tuba City AZ 86045-0600. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Pacheco, Ivan F can be contacted via phone (928) 283-2501.Contact Information
Primary practice address
167 North Main Street
Tuba City AZ 86045-0600
Phone: (928) 283-2501
Fax: (928) 283-2677
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | D6669 | Arizona |
Profile Details
| NPI number | 1073553632 |
|---|---|
| LBN Legal business name | Pacheco, Ivan F |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 8th, 2006 |
| Last updated | Mar 31st, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073553632 | NPPES |
| Arizona | MEDICAID | 687709 |
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