Provider Demographics
NPI:1184850232
Name:ALVARADO, ROBERTO C (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:C
Last Name:ALVARADO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 962707
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79996-2707
Mailing Address - Country:US
Mailing Address - Phone:915-855-8874
Mailing Address - Fax:915-921-7842
Practice Address - Street 1:960 AVE. AMERICAS
Practice Address - Street 2:
Practice Address - City:CD. JUAREZ, CHIH
Practice Address - State:MX
Practice Address - Zip Code:32310
Practice Address - Country:MX
Practice Address - Phone:915-855-8874
Practice Address - Fax:915-921-7842
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ5961531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice