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General NPI Number Information
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NPI Number | 1609096759
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Entity Type | Individual
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Provider Name | MANUEL RAMON SANTIAGO D.M.D
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Gender | Male
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Dates
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Enumeration Date | 04/30/2007
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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 LIZZIE GRAHAM HG-15 7MA SECCION LEVITTOWN
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City | TOA BAJA
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State | PR
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Zip | 00949
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Country | US
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Telephone | 787-261-4670
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Fax |
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Provider Business Mailing Address
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Address Line | SANTA PAULA LAS COLINAS #88
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City | GUAYNABO
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State | PR
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Zip | 00969
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Country | US
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Telephone | 787-272-0469
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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 | 2358
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License Number State | PR
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