Provider Demographics
NPI:1003901091
Name:JOGLAR, RAFAEL A (DMD)
Entity Type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:A
Last Name:JOGLAR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 CALLE PADIAL
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-3134
Mailing Address - Country:US
Mailing Address - Phone:787-854-3674
Mailing Address - Fax:787-854-3674
Practice Address - Street 1:13 CALLE PADIAL
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-5012
Practice Address - Country:US
Practice Address - Phone:787-854-3674
Practice Address - Fax:787-854-3674
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice