Provider Demographics
NPI:1508005984
Name:VAZQUEZ-MORALES, DAVID E (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:VAZQUEZ-MORALES
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:PO BOX 870
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-0870
Mailing Address - Country:US
Mailing Address - Phone:787-744-3087
Mailing Address - Fax:787-704-8165
Practice Address - Street 1:A1 AVE MUNOZ RIVERA SUITE 302
Practice Address - Street 2:CIRUGIA AMBULATORIA
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00726
Practice Address - Country:US
Practice Address - Phone:787-744-3087
Practice Address - Fax:787-704-8165
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-09
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0531291223S0112X
PR27581223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery