Provider Demographics
NPI:1437186053
Name:CABRERA, JEANETTE (DMD)
Entity Type:Individual
Prefix:DR
First Name:JEANETTE
Middle Name:
Last Name:CABRERA
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:AVENTURA ENCANTADA
Mailing Address - Street 2:APT#6602
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976
Mailing Address - Country:US
Mailing Address - Phone:787-701-2613
Mailing Address - Fax:787-701-2613
Practice Address - Street 1:AVE. FIDALGO DIAZ VILLA FONTANA
Practice Address - Street 2:AL-4
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983
Practice Address - Country:US
Practice Address - Phone:787-701-2613
Practice Address - Fax:787-701-2613
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice