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Individual

DR. IVAN JOSE SANTIAGO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D

Contact information

Practice address
85 JOSE CELSO BARBOSA, LAS PIEDRAS, PR 00771
(787) 647-7330
Mailing address
89 AVE DE DIEGO PMB 643, SUITE 105, SAN JUAN, PR 00927-6372
(787) 647-7330

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2507
PR

Other

Enumeration date
10/18/2006
Last updated
07/08/2007
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