Provider Demographics
NPI:1194867119
Name:RAMOS, JORGE LUIS (DMD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:LUIS
Last Name:RAMOS
Suffix:
Gender:M
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:URB. PENUELAS VALLEY
Mailing Address - Street 2:CALLE 2 #31
Mailing Address - City:PENUELAS
Mailing Address - State:PR
Mailing Address - Zip Code:00624
Mailing Address - Country:US
Mailing Address - Phone:787-836-0454
Mailing Address - Fax:787-836-0454
Practice Address - Street 1:301 CALLE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:PENUELAS
Practice Address - State:PR
Practice Address - Zip Code:00624-2009
Practice Address - Country:US
Practice Address - Phone:787-836-0454
Practice Address - Fax:787-836-0454
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRD16591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice