Provider Demographics
NPI:1407959778
Name:LLORENS, ENRIQUE ALBERTO (DMD)
Entity Type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:ALBERTO
Last Name:LLORENS
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 2284
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-2284
Mailing Address - Country:US
Mailing Address - Phone:787-864-0965
Mailing Address - Fax:787-866-3443
Practice Address - Street 1:CENTRO COMERCIAL PLAZA GUAYAMA
Practice Address - Street 2:SUITE 80
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-864-0965
Practice Address - Fax:787-866-3443
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRD-19661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice