Provider Demographics
NPI:1073553798
Name:BERRIOS, MARIENALDY (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARIENALDY
Middle Name:
Last Name:BERRIOS
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 1:203 VIA DEL RIO
Mailing Address - Street 2:URB. VALLE SAN LUIS
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-3371
Mailing Address - Country:US
Mailing Address - Phone:787-746-4911
Mailing Address - Fax:
Practice Address - Street 1:CALLE FRANCISCO. CRUZ HADDOCK 2
Practice Address - Street 2:
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739-1330
Practice Address - Country:US
Practice Address - Phone:787-739-8182
Practice Address - Fax:787-739-8190
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1928122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist