Individual
KEISY BONANO BAEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
200 CARR 842, APT. P101, SAN JUAN, PR 00926
(787) 223-1776
Mailing address
200 CARR 842 BOX105, APT. P101, SAN JUAN, PR 00926
(787) 223-1776
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3501
PR
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
08/01/2022
Last updated
06/20/2024
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