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General NPI Number Information
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NPI Number | 1053946244
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Entity Type | Individual
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Provider Name | DENISHA MARIE BERRIOS MIRANDA DMD
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Gender | Female
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Dates
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Enumeration Date | 03/08/2020
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Last Update Date | 09/06/2022
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Provider Practice Location Address
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Address Line | AVE. SAN CLAUDIO #390
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-748-2025
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Fax |
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Provider Business Mailing Address
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Address Line | HC 67 BOX 15090
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City | BAYAMON
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State | PR
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Zip | 00956-9510
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Country | US
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Telephone | 787-664-0935
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3355
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License Number State | PR
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