Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | DS036408 | PA |
NPI | 1043357429 |
---|---|
Provider Name | Dr. Nestor Foronda |
First Address | New Castle, PA 16101-3680 |
Second Address | Pittsburgh, PA 15238-2816 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 12/12/2017 |