Provider Demographics
NPI:1427565050
Name:ALCANTARA, MARIA (RDH)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:ALCANTARA
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7490 S CAMINO DE OESTE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85757
Mailing Address - Country:US
Mailing Address - Phone:520-879-6141
Mailing Address - Fax:520-879-6188
Practice Address - Street 1:7490 S CAMINO DE OESTE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85757-9308
Practice Address - Country:US
Practice Address - Phone:520-879-6141
Practice Address - Fax:520-879-6188
Is Sole Proprietor?:No
Enumeration Date:2018-01-04
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4821124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist