Provider Demographics
NPI:1184818759
Name:COLON-ALCARAZ, DIVYA CHRISTINE (DMD)
Entity Type:Individual
Prefix:DR
First Name:DIVYA
Middle Name:CHRISTINE
Last Name:COLON-ALCARAZ
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 1:270 CALLE JOYUDA
Mailing Address - Street 2:VILLAS DE LA PLAYA
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-6046
Mailing Address - Country:US
Mailing Address - Phone:787-640-2189
Mailing Address - Fax:
Practice Address - Street 1:270 CALLE JOYUDA
Practice Address - Street 2:VILLAS DE LA PLAYA
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-6046
Practice Address - Country:US
Practice Address - Phone:787-640-2189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2073122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist