Provider Demographics
NPI:1427186550
Name:PINA, LILBA (DMD)
Entity Type:Individual
Prefix:DR
First Name:LILBA
Middle Name:
Last Name:PINA
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:COND. CORDOBA PARK
Mailing Address - Street 2:400 BO. TORTUGO APT. 3
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-720-3856
Mailing Address - Fax:787-763-3967
Practice Address - Street 1:URB. MONTECARLOS
Practice Address - Street 2:A- 16
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693
Practice Address - Country:US
Practice Address - Phone:787-855-1242
Practice Address - Fax:787-763-3967
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR26221223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics