Provider Demographics
NPI:1144248527
Name:LOREDO, ABEL (DDS)
Entity type:Individual
Prefix:DR
First Name:ABEL
Middle Name:
Last Name:LOREDO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 PENNY LN
Mailing Address - Street 2:SUITE #103
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-6017
Mailing Address - Country:US
Mailing Address - Phone:831-724-1933
Mailing Address - Fax:831-724-6872
Practice Address - Street 1:55 PENNY LN
Practice Address - Street 2:SUITE #103
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-6017
Practice Address - Country:US
Practice Address - Phone:831-724-1933
Practice Address - Fax:831-724-6872
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA324821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice