Healthcare Provider Details

I. General information

NPI: 1720905110
Provider Name (Legal Business Name): GABRIEL ARMANDO COLON - SOTO SR. DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARRETERA 3, KM 8.3, AVENIDA 65 DE INFANTERIA HOSPITAL DE LA UPR DR. FEDERICO TRILL
CAROLINA PR
00984
US

IV. Provider business mailing address

PO BOX 365067 ESCUELA DE MEDICINA DENTAL - GPR PROGRAM
SAN JUAN PR
00936-5067
US

V. Phone/Fax

Practice location:
  • Phone: 787-757-1800
  • Fax:
Mailing address:
  • Phone: 787-758-2525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: