Provider Demographics
NPI:1376516237
Name:DELATORRE, ANA J (DMD)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:J
Last Name:DELATORRE
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:URB. ROYAL TOWN
Mailing Address - Street 2:A-20 CALLE 13
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:787-799-1170
Mailing Address - Fax:787-799-5052
Practice Address - Street 1:URB. ROYAL TOWN
Practice Address - Street 2:CALLE 13 A-20
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-799-1170
Practice Address - Fax:787-799-5052
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-10
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR41401OtherSSS PROVIDER ID