Provider Demographics
NPI:1033582630
Name:LOYOLA, DELIAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:DELIAN
Middle Name:
Last Name:LOYOLA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 CALLE ALDEBARAN STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920-4227
Mailing Address - Country:US
Mailing Address - Phone:787-230-7573
Mailing Address - Fax:
Practice Address - Street 1:544 CALLE ALDEBARAN EDIF EDGEWELL OFIC 102
Practice Address - Street 2:URB ALTAMIRA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920
Practice Address - Country:US
Practice Address - Phone:787-230-7573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-04
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR32071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice