Healthcare Provider Details

I. General information

NPI: 1427053016
Provider Name (Legal Business Name): MAGDA B PRATS DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

568 CALLE CESAR GONZALEZ
SAN JUAN PR
00918-3738
US

IV. Provider business mailing address

#435 ARBOLES DE MONTEHIEDRA
SAN JUAN PR
00926
US

V. Phone/Fax

Practice location:
  • Phone: 787-767-7148
  • Fax:
Mailing address:
  • Phone: 787-708-8419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number1783
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: