Provider Demographics
NPI:1396830964
Name:SANCHEZ-CRUZ, ANNETTE (DM)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:SANCHEZ-CRUZ
Suffix:
Gender:F
Credentials:DM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CALLE MERCEDITA SERRALLES
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-3902
Mailing Address - Country:US
Mailing Address - Phone:787-735-1741
Mailing Address - Fax:
Practice Address - Street 1:AVE BETANCES H 56
Practice Address - Street 2:HERMANAS DAVILA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-787-0078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2465OtherDENTIST LICENCE PR