Healthcare Provider Details

I. General information

NPI: 1417954413
Provider Name (Legal Business Name): HECTOR M. NATER DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 12/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2053 PONCE BY PASS AVE. SUITE 205
PONCE PR
00717-1309
US

IV. Provider business mailing address

609 TITO CASTRO AVE. SUITE 102 PMB 388
PONCE PR
00716-2232
US

V. Phone/Fax

Practice location:
  • Phone: 787-841-4911
  • Fax: 787-841-4911
Mailing address:
  • Phone: 787-841-4911
  • Fax: 787-841-4911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number1189
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: