Provider Demographics
NPI:1497740385
Name:URRUTIA, CARLOS RAMON (DMD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:RAMON
Last Name:URRUTIA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1246
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00977-1246
Mailing Address - Country:US
Mailing Address - Phone:787-769-0840
Mailing Address - Fax:939-204-1237
Practice Address - Street 1:E122 CARR 860
Practice Address - Street 2:ROLLING HILLS
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-7010
Practice Address - Country:US
Practice Address - Phone:787-769-0840
Practice Address - Fax:939-204-1237
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-16
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice