Provider Demographics
NPI:1265678635
Name:SANTANA, TERESA Y (DMD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:Y
Last Name:SANTANA
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 361965
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-1965
Mailing Address - Country:US
Mailing Address - Phone:787-793-2438
Mailing Address - Fax:787-782-4645
Practice Address - Street 1:D7 CALLE GARDEN MDW
Practice Address - Street 2:GARDEN HILLS NORTE
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966-2615
Practice Address - Country:US
Practice Address - Phone:787-793-2438
Practice Address - Fax:787-782-4645
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1319122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist