Provider Demographics
NPI:1033185426
Name:NEGRON, PEPE MIGUEL (DMD)
Entity Type:Individual
Prefix:MR
First Name:PEPE
Middle Name:MIGUEL
Last Name:NEGRON
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:PO BOX 1278
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-1278
Mailing Address - Country:US
Mailing Address - Phone:787-790-0282
Mailing Address - Fax:787-790-5403
Practice Address - Street 1:48 CALLE CARAZO
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-5635
Practice Address - Country:US
Practice Address - Phone:787-790-0282
Practice Address - Fax:787-790-5403
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice