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General NPI Number Information
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NPI Number | 1831398569
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Entity Type | Individual
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Provider Name | YAIRA JULISSA SANTANA D.M.D
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Gender | Female
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Dates
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Enumeration Date | 07/12/2007
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Last Update Date | 07/12/2007
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Provider Practice Location Address
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Address Line | 208 CALLE MONTECARLO PALMAS DEL MAR
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City | HUMACAO
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State | PR
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Zip | 00791-6189
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Country | US
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Telephone | 787-594-6602
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8582
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City | HUMACAO
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State | PR
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Zip | 00792-8582
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Country | US
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Telephone | 787-594-6602
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Fax | 787-733-5566
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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 | 2779
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License Number State | PR
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