Provider Demographics
NPI:1215562590
Name:VELEZ VELEZ, LAURA (DMD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:VELEZ VELEZ
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 687
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-0687
Mailing Address - Country:US
Mailing Address - Phone:787-519-3557
Mailing Address - Fax:
Practice Address - Street 1:100 CALLE HERNAN ALVAREZ STE 201
Practice Address - Street 2:
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-4175
Practice Address - Country:US
Practice Address - Phone:787-264-2810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-07
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3367122300000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist