Healthcare Provider Details

I. General information

NPI: 1437033115
Provider Name (Legal Business Name): LETICIA G ALVAREZ DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVENIDA MADERO Y CALLE 15
SAN LUIS RIO COLORADO SONORA
83448
MX

IV. Provider business mailing address

870 W 34TH ST
YUMA AZ
85365-4372
US

V. Phone/Fax

Practice location:
  • Phone: 928-509-1279
  • Fax:
Mailing address:
  • Phone: 928-509-1279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number3682991
License Number StateZZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: