Provider Demographics
NPI:1205846565
Name:NUNEZ GONZALEZ, LOURDES LYMARIE (DMD)
Entity Type:Individual
Prefix:DR
First Name:LOURDES
Middle Name:LYMARIE
Last Name:NUNEZ 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 1:528 AVE ANDALUCIA
Mailing Address - Street 2:PUERTO NUEVO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920-4130
Mailing Address - Country:US
Mailing Address - Phone:787-273-1410
Mailing Address - Fax:787-706-1292
Practice Address - Street 1:528 AVE ANDALUCIA
Practice Address - Street 2:PUERTO NUEVO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-4130
Practice Address - Country:US
Practice Address - Phone:787-273-1410
Practice Address - Fax:787-706-1292
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice