Provider Demographics
NPI:1467582189
Name:LUGO, FABIEL ARNALDO (DDS)
Entity Type:Individual
Prefix:DR
First Name:FABIEL
Middle Name:ARNALDO
Last Name:LUGO
Suffix:
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 1:205B TORRE SAN CRISTOBAL
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-2847
Mailing Address - Country:US
Mailing Address - Phone:787-259-0253
Mailing Address - Fax:
Practice Address - Street 1:205B TORRE SAN CRISTOBAL
Practice Address - Street 2:
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780-2847
Practice Address - Country:US
Practice Address - Phone:787-259-0253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice