Provider Demographics
NPI:1063676609
Name:RAMIREZ, JUAN M (DDS)
Entity Type:Individual
Prefix:MR
First Name:JUAN
Middle Name:M
Last Name:RAMIREZ
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 1:1108 DOBIE DRIVE
Mailing Address - Street 2:SUITE #101
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074
Mailing Address - Country:US
Mailing Address - Phone:972-509-9505
Mailing Address - Fax:972-509-9360
Practice Address - Street 1:1108 DOBIE DRIVE
Practice Address - Street 2:SUITE #101
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074
Practice Address - Country:US
Practice Address - Phone:972-509-9505
Practice Address - Fax:972-509-9360
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX01977122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist