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Individual

DR. NORMA IRIS DE LEON-TELLADO

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
D.M.D.

Contact information

Practice address
255 CALLE ELEONOR ROOSEVELT, SAN JUAN, PR 00918-2806
(787) 763-9190
Mailing address
RR 36 BOX 8233, SAN JUAN, PR 00926-9562
(787) 717-3435

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2677
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
42518
NUM. PROVEEDOR TRIPLE S
PR
01
739 0060
NUM. PROVEEDOR HUMANA
PR
01
D000210
NUM. PROVEEDOR MENONITA
PR
01
P-890
NUM. PROVEEDOR IMC
PR
Enumeration date
04/19/2006
Last updated
07/08/2007
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