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General NPI Number Information
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NPI Number | 1538456546
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Entity Type | Individual
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Provider Name | NELSON RUIZ-FEBO DMD
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Gender | Male
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Dates
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Enumeration Date | 06/29/2011
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Last Update Date | 09/22/2020
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Provider Practice Location Address
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Address Line | VILLA DEL ROSARIO CALLE 2 A-3
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City | NAGUABO
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State | PR
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Zip | 00781
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Country | US
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Telephone | 787-460-0283
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Fax |
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Provider Business Mailing Address
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Address Line | URB.EL MIRADOR DE CUPEY A-6 CALLE 2
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City | SAN JUAN
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State | PR
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Zip | 00926-7545
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Country | US
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Telephone | 787-460-0283
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 10173
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 3150
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License Number State | PR
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