Provider Demographics
NPI:1023196409
Name:CORDERO, RAUL FRANCISCO (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAUL
Middle Name:FRANCISCO
Last Name:CORDERO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6663
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-6663
Mailing Address - Country:US
Mailing Address - Phone:787-832-5155
Mailing Address - Fax:
Practice Address - Street 1:1118 CALLE JOSE E ARRARAS
Practice Address - Street 2:MAYAGUEZ TERRACE
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-6602
Practice Address - Country:US
Practice Address - Phone:787-832-5155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR20511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice