Individual
DR. DIEGO BRAVO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
164 CALLE DELFIN OLMO, ARECIBO, PR 00612-4637
(787) 878-5004
(787) 878-5004
Mailing address
PO BOX 144100, ARECIBO, PR 00614-4100
(787) 878-5004
(787) 878-5004
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2542
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40679
TRIPLE S
PR
01
—
J043108
CRUZ AZUL
PR
Enumeration date
08/30/2006
Last updated
07/08/2007
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