MEDICARE: NOEL I DONATE DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	1020	PR

General Provider Information

NPI Number	:	1679556021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOEL I DONATE DDS

Provider Business Mailing Address
First Line	:	PO BOX 2313
Second Line	:
City	:	VEGA BAJA
State	:	PR
Zip	:	00694-2313
Country	:	US
Telephone Number	:	787-858-5155
Fax Number	:	787-807-0861

Provider Business Practice Location Address
First Line	:	CARR 686 1A-1 URB VILLA REAL
Second Line	:
City	:	VEGA BAJA
State	:	PR
Zip	:	00693
Country	:	US
Telephone Number	:	787-858-5155
Fax Number	:	787-807-0861

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2005
Last Update Date	:	05/31/2026

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