Healthcare Provider Details

I. General information

NPI: 1093508525
Provider Name (Legal Business Name): CARLOS A NUNEZ AYOROA DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2025
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CLINICA DENTAL LA MONTANA PR-152 KM 12.7 BO. CEDRO ARRIBA
NARANJITO PR
00719
US

IV. Provider business mailing address

2021 CALLE EXTREMADURA
PONCE PR
00730-4079
US

V. Phone/Fax

Practice location:
  • Phone: 787-919-5030
  • Fax:
Mailing address:
  • Phone: 787-919-5030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number3590
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: