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General NPI Number Information
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NPI Number | 1083694525
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Entity Type | Individual
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Provider Name | FANNY MARIE GARRATON D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/19/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1774 AVE PAZ GRANELA SANTIAGO IGLESIAS
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City | SAN JUAN
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State | PR
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Zip | 00921-3628
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Country | US
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Telephone | 787-782-9777
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Fax | 787-782-9775
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Provider Business Mailing Address
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Address Line | PO BOX 7887 PMB 148
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City | GUAYNABO
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State | PR
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Zip | 00970-7887
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Country | US
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Telephone | 787-782-9777
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Fax | 787-782-9775
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 1348
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License Number State | PR
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