Healthcare Provider Details

I. General information

NPI: 1962954818
Provider Name (Legal Business Name): NATALIA VANESSA RAMIREZ RODRIGUEZ D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2016
Last Update Date: 04/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 EXT CALLE SOL
SAN GERMAN PUERTO RICO
00683
UM

IV. Provider business mailing address

R3 CALLE CEDRO URB VALLE HERMOSO NORTE
HORMIGUEROS PR
00660-1403
US

V. Phone/Fax

Practice location:
  • Phone: 787-264-5437
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3235
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: