Healthcare Provider Details

I. General information

NPI: 1083878912
Provider Name (Legal Business Name): ARNALDO R VALENCIA PINTADO DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ARNALDO R VALENCIA PINTADO DMD

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 08/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CAROLINA SHOPP CTR SUITE 305 FLOOR 6
CAROLINA PR
00985-5672
US

IV. Provider business mailing address

CAROLINA SHOPP CTR SUITE 305 FLOOR 6
CAROLINA PR
00985-5672
US

V. Phone/Fax

Practice location:
  • Phone: 787-641-4646
  • Fax:
Mailing address:
  • Phone: 787-641-4646
  • Fax: 787-750-4646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number2815
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: