Healthcare Provider Details

I. General information

NPI: 1962864868
Provider Name (Legal Business Name): ADRIANA NUNEZ ROMERO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 03/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE FELIX CONTRERAS Y CALLE 7 #700 COL. COMERCIAL
SAN LUIS RIO COLORADO SONORA
83449
MX

IV. Provider business mailing address

4364 BONITA RD #233
BONITA CA
91902-1421
US

V. Phone/Fax

Practice location:
  • Phone: 011526535342343
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number1355574
License Number StateZZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: