Provider Demographics
NPI:1437548658
Name:NUNEZ-ORTA, JOSE JUAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:JUAN
Last Name:NUNEZ-ORTA
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 1:2053 PONCE BY PASS
Mailing Address - Street 2:EDIFICIO CENTRO CARIBE SUITE 202
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-0000
Mailing Address - Country:US
Mailing Address - Phone:787-244-7410
Mailing Address - Fax:
Practice Address - Street 1:2053 PONCE BY PASS
Practice Address - Street 2:EDIFICIO CENTRO CARIBE SUITE 202
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1308
Practice Address - Country:US
Practice Address - Phone:787-244-7410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-12
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3185122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist