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General NPI Number Information
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NPI Number | 1346600608
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Entity Type | Individual
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Provider Name | ANDREA STODDARD RAMOS DMD
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Gender | Female
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Dates
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Enumeration Date | 02/29/2016
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Last Update Date | 03/20/2018
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Provider Practice Location Address
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Address Line | URB ALTAMESA 1324 AVE SAN ALFONSO
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City | SAN JUAN
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State | PR
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Zip | 00921
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Country | US
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Telephone | 787-767-7148
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Fax |
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Provider Business Mailing Address
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Address Line | URB. LOS JARDINES #129 FLOR DE LUZ
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City | GARROCHALES
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State | PR
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Zip | 00652
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Country | US
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Telephone |
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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 | 3247
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License Number State | PR
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