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General NPI Number Information
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NPI Number | 1073553798
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Entity Type | Individual
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Provider Name | MARIENALDY BERRIOS D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | CALLE FRANCISCO. CRUZ HADDOCK 2
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City | CIDRA
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State | PR
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Zip | 00739-1330
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Country | US
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Telephone | 787-739-8182
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Fax | 787-739-8190
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Provider Business Mailing Address
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Address Line | 203 VIA DEL RIO URB. VALLE SAN LUIS
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City | CAGUAS
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State | PR
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Zip | 00725-3371
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Country | US
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Telephone | 787-746-4911
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 1928
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License Number State | PR
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