Healthcare Provider Details

I. General information

NPI: 1609853852
Provider Name (Legal Business Name): ERNESTO G CURBELO MARRERO DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2005
Last Update Date: 03/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

D14 CALLE ANICETO DIAZ GOLDEN HILL
TRUJILLO ALTO PR
00976-2505
US

IV. Provider business mailing address

PO BOX 1896 PUERTO NUEVO
TRUJILLO ALTO PR
00977-1896
US

V. Phone/Fax

Practice location:
  • Phone: 787-761-4845
  • Fax: 787-755-2222
Mailing address:
  • Phone: 787-587-5380
  • Fax: 939-204-1224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2688
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: