Provider Demographics
NPI:1376756841
Name:BERMUDEZ, MARIA M (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:M
Last Name:BERMUDEZ
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 1953
Mailing Address - Street 2:
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-1953
Mailing Address - Country:US
Mailing Address - Phone:787-768-0485
Mailing Address - Fax:787-776-5461
Practice Address - Street 1:CALLE 401 BLO 143 #6
Practice Address - Street 2:VILLA CAROLINA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-768-0485
Practice Address - Fax:787-776-5461
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2391122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
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PR5849455557Medicare UPIN
PR206452Medicare UPIN
PR66056806701Medicare UPIN
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