Individual
CRISTINA ORTIZ-DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD, MSD
Contact information
Practice address
36 CARR 2 STE 301, VEGA ALTA, PR 00692-6092
(787) 883-6234
Mailing address
67 CALLE NOGAL, MONTECASINO, TOA ALTA, PR 00953-3725
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
058198-1
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
3295
PR
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
PRV-FP-108-20
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038821200
—
PR
Enumeration date
05/01/2014
Last updated
09/01/2021
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