Provider Demographics
NPI:1225243538
Name:PEREZ, NELMARIE J (DMD)
Entity Type:Individual
Prefix:DR
First Name:NELMARIE
Middle Name:J
Last Name:PEREZ
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 1:225 CALLE VIOLETA
Mailing Address - Street 2:URB. SAN FRANCISCO
Mailing Address - City:RIO PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00927-6223
Mailing Address - Country:US
Mailing Address - Phone:787-587-8147
Mailing Address - Fax:
Practice Address - Street 1:BG176 CALLE 54
Practice Address - Street 2:JARDINES DE RIO GRANDE
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745-2616
Practice Address - Country:US
Practice Address - Phone:787-887-7281
Practice Address - Fax:787-888-7008
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1708122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR7450056OtherHUMANA
PR40178OtherTRIPLE S