Provider Demographics
NPI:1407508823
Name:GUZMAN PIBERNUS, NIKAURY (DMD)
Entity Type:Individual
Prefix:
First Name:NIKAURY
Middle Name:
Last Name:GUZMAN PIBERNUS
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 1137
Mailing Address - Street 2:
Mailing Address - City:VILLALBA
Mailing Address - State:PR
Mailing Address - Zip Code:00766-1137
Mailing Address - Country:US
Mailing Address - Phone:787-673-8478
Mailing Address - Fax:
Practice Address - Street 1:151 AVE CESAR GONZALEZ 3702
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-673-8478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3397122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist