Provider Demographics
NPI:1144377706
Name:FERNANDEZ RIOS, MILITZA (DMD)
Entity Type:Individual
Prefix:
First Name:MILITZA
Middle Name:
Last Name:FERNANDEZ RIOS
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 1:1225 CALLE MARGINAL VILLAMAR
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979-6328
Mailing Address - Country:US
Mailing Address - Phone:787-727-8960
Mailing Address - Fax:787-726-0802
Practice Address - Street 1:1225 CALLE MARGINAL VILLAMAR
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979
Practice Address - Country:US
Practice Address - Phone:787-727-8960
Practice Address - Fax:787-726-0802
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR891122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist