Provider Demographics
NPI:1104380799
Name:PEREZ-CISNEROS ARMENTEROS, CARINA (DMD)
Entity Type:Individual
Prefix:
First Name:CARINA
Middle Name:
Last Name:PEREZ-CISNEROS ARMENTEROS
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:D1 CAMINO LAS PALMAS
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5909
Mailing Address - Country:US
Mailing Address - Phone:939-639-0888
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF PUERTO RICO STE B130C
Practice Address - Street 2:RECINTO DE CIENCIAS MEDICAS PISO 1
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936-5067
Practice Address - Country:US
Practice Address - Phone:787-758-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-28
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3272122300000X
TX361931223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
No122300000XDental ProvidersDentist