Individual
BEATRIZ ELENA IBANEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
SAN GERMAN MEDICAL PLAZA CARR # 2 KM174, SUITE 201, SAN GERMAN, PR 00683-0188
(787) 892-1010
(787) 892-1011
Mailing address
PO BOX 188, SAN GERMAN, PR 00683-0188
(797) 892-1010
(787) 892-1011
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
1759
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1759
LICENSE NUMBER
PR
Enumeration date
09/22/2006
Last updated
07/08/2007
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