Provider Demographics
NPI:1356444756
Name:ITURRINO, CARLOS R (DMD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:R
Last Name:ITURRINO
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:PO BOX 489
Mailing Address - Street 2:
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-0489
Mailing Address - Country:US
Mailing Address - Phone:787-876-2531
Mailing Address - Fax:787-876-2531
Practice Address - Street 1:#74 HERNAIZ AVE PALMER CORNER
Practice Address - Street 2:01
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729
Practice Address - Country:US
Practice Address - Phone:787-876-2531
Practice Address - Fax:787-876-2531
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice