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GUSTAVO PARDO DDS
>> Dentist >> Dental ProvidersRegistrant NPI Number: 1306254156
Individual Registrant: GUSTAVO PARDO DDS
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
930 S MAIN ST LABELLE, FL 33935-4448 US
Tel: 863-675-0387 Fax: 863-675-3246
Tel: 863-675-0387 Fax: 863-675-3246
Contact information for business:
PO BOX 919771 ORLANDO, FL 32891-9771 US
Tel: 239-278-3600 Fax: 239-226-4650
Tel: 239-278-3600 Fax: 239-226-4650
Registration Information:
NPI: 1306254156
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 122300000X | Dental Providers Dentist | FL | DN20829 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 012768900 | FL | 05 |
