Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MAGNOLIA PEDRAZA, D.M.D., M.S.
Active Sole ProprietorDR. MAGNOLIA PEDRAZA, D.M.D., M.S. is a Periodontology healthcare provider located in FORSYTH, Illinois. NPI 1689746281 is currently active in the NPPES registry. Verify at CMS.
Periodontology · FORSYTH, IL
Registration Details
- NPI Number
- 1689746281
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Nov 15, 2006 (19.784181363689 yrs)
- Last Updated
- Jul 8, 2007
- License
-
021.001709 019.02272 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
241 W WEAVER RDSUITE 220FORSYTH, IL, 625359762Browse IL providers · Browse ZIP 62535
- Phone
- 2178760547
- Fax
- 2178760601
- Primary Specialty
-
Periodontology
1223P0300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.