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General NPI Number Information
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NPI Number | 1265663314
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Entity Type | Individual
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Provider Name | GABRIEL FUENTES-ARROYO DMD
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Gender | Male
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 03/07/2016
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Provider Practice Location Address
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Address Line | 60 CALLE CRISTOBAL COLON
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City | YABUCOA
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State | PR
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Zip | 00767-3616
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Country | US
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Telephone | 787-893-2044
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Fax |
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Provider Business Mailing Address
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Address Line | 60 CALLE CRISTOBAL COLON
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City | YABUCOA
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State | PR
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Zip | 00767-3616
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Country | US
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Telephone | 787-893-2044
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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 | 054423
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 2869
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License Number State | PR
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