NPI 1073553632

Ivan F Pacheco, DMD

Practitioner Dentist Tuba City, AZ

Practice location

Address: 167 North Main Street, Tuba City, AZ 86045-0600
Phone: (928) 283-2501
Fax: (928) 283-2677
Mailing address: PO Box 600 167 North Main Street, Tuba City, AZ 86045-0600

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence D6669 (AZ)

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Registry record

NPI: 1073553632
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 Jun 2006
Record last updated: 31 Mar 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.