Provider Demographics
NPI:1336330372
Name:OTERO PADRO, AMARILIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMARILIS
Middle Name:
Last Name:OTERO PADRO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR. #2 KM 93.9 BO. MEMBRILLO
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627
Mailing Address - Country:US
Mailing Address - Phone:787-262-4074
Mailing Address - Fax:787-262-4074
Practice Address - Street 1:CARR 2 KM 93.9
Practice Address - Street 2:BARRIO MEMBRILLO
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627
Practice Address - Country:US
Practice Address - Phone:787-262-4074
Practice Address - Fax:787-262-4074
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice