Provider Demographics
NPI:1265663314
Name:FUENTES-ARROYO, GABRIEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:
Last Name:FUENTES-ARROYO
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 1:60 CALLE CRISTOBAL COLON
Mailing Address - Street 2:
Mailing Address - City:YABUCOA
Mailing Address - State:PR
Mailing Address - Zip Code:00767-3616
Mailing Address - Country:US
Mailing Address - Phone:787-893-2044
Mailing Address - Fax:
Practice Address - Street 1:60 CALLE CRISTOBAL COLON
Practice Address - Street 2:
Practice Address - City:YABUCOA
Practice Address - State:PR
Practice Address - Zip Code:00767-3616
Practice Address - Country:US
Practice Address - Phone:787-893-2044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054423122300000X
PR28691223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist