Provider Demographics
NPI:1194393348
Name:SOTO GONZALEZ, ALISHA CRISTEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALISHA
Middle Name:CRISTEL
Last Name:SOTO GONZALEZ
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:PO BOX 2051
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-2051
Mailing Address - Country:US
Mailing Address - Phone:939-404-0140
Mailing Address - Fax:
Practice Address - Street 1:170 BDA FELIX CORDOVA DAVILA
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-6021
Practice Address - Country:US
Practice Address - Phone:787-854-7429
Practice Address - Fax:787-854-7429
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3457122300000X, 1223P0221X
PR390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program