Provider Demographics
NPI:1497259147
Name:LLAURADOR CARABALLO, NATALIA ESTEFANIA (DMD)
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:ESTEFANIA
Last Name:LLAURADOR CARABALLO
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 1:2431 BLVD LUIS A FERRE STE 202
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-2115
Mailing Address - Country:US
Mailing Address - Phone:787-840-0080
Mailing Address - Fax:
Practice Address - Street 1:2431 BLVD LUIS A FERRE STE 202
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-2115
Practice Address - Country:US
Practice Address - Phone:787-840-0080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-19
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR33001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics