Healthcare Provider Details

I. General information

NPI: 1043674500
Provider Name (Legal Business Name): CAMILLE NESTE M.P.H.,D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2016
Last Update Date: 07/21/2022
Certification Date: 02/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 CALLE DE DIEGO E
MAYAGUEZ PR
00680-5497
US

IV. Provider business mailing address

PO BOX 2896
MAYAGUEZ PR
00681-2896
US

V. Phone/Fax

Practice location:
  • Phone: 787-833-3548
  • Fax: 787-265-7788
Mailing address:
  • Phone: 787-833-3548
  • Fax: 787-265-7788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN1857503
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number003322
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: