# EL PASO PELLICANO FAMILY DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770396798
- **Authorized official:** DR. JASVINDER BADWALZ DMD (OWNER DENTIST)
- **Authorized official phone:** (916) 747-8534

## Contact information

- **Practice address:** 10039 DYER ST, EL PASO, TX 79924-4136
- **Practice address phone:** (915) 759-7000
- **Mailing address:** 10039 DYER ST, EL PASO, TX 79924-4136
- **Mailing address phone:** (915) 759-7000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 01/31/2025
- **Last updated:** 01/31/2025