Healthcare Provider Details

I. General information

NPI: 1760228407
Provider Name (Legal Business Name): WILMARY SANTIAGO-RAMOS DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2024
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 AVE FD ROOSEVELT TORRE DE PLAZA LAS AMERICAS SUITE 812
SAN JUAN PR
00918
US

IV. Provider business mailing address

PO BOX 404
CAMUY PR
00627-0404
US

V. Phone/Fax

Practice location:
  • Phone: 787-751-6317
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number3565
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: