Provider Demographics
NPI:1457495657
Name:CANTU, NORBERTO JR (DDS)
Entity Type:Individual
Prefix:
First Name:NORBERTO
Middle Name:
Last Name:CANTU
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-3804
Mailing Address - Country:US
Mailing Address - Phone:956-487-4746
Mailing Address - Fax:956-487-4468
Practice Address - Street 1:204 E 2ND ST
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-3804
Practice Address - Country:US
Practice Address - Phone:956-487-4746
Practice Address - Fax:956-487-4468
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX194801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice