Provider Demographics
NPI:1114781705
Name:ARROYO RENTERIA, NEREIDA
Entity Type:Individual
Prefix:
First Name:NEREIDA
Middle Name:
Last Name:ARROYO RENTERIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 N TERRACE AVE UNIT 86
Mailing Address - Street 2:
Mailing Address - City:NOGALES
Mailing Address - State:AZ
Mailing Address - Zip Code:85621
Mailing Address - Country:US
Mailing Address - Phone:520-980-1002
Mailing Address - Fax:
Practice Address - Street 1:AVE OBREGON 175 COL FUNDO LEGAL
Practice Address - Street 2:
Practice Address - City:NOGALES
Practice Address - State:SONORA
Practice Address - Zip Code:84030
Practice Address - Country:MX
Practice Address - Phone:520-980-1002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ42291561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice