Provider Demographics
NPI:1164976809
Name:IRIZARRY TOLEDO, MARIA M (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:M
Last Name:IRIZARRY TOLEDO
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:RR 2 BOX 4056
Mailing Address - Street 2:
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-7003
Mailing Address - Country:US
Mailing Address - Phone:787-243-1737
Mailing Address - Fax:
Practice Address - Street 1:CARR 164 KM 9.6
Practice Address - Street 2:SECTOR EL DESVIO
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00957
Practice Address - Country:US
Practice Address - Phone:787-243-1737
Practice Address - Fax:787-869-1800
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-11
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR32861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice