Provider Demographics
NPI:1508991076
Name:LLADO ORTEGA, MAYRA LETICIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:MAYRA
Middle Name:LETICIA
Last Name:LLADO ORTEGA
Suffix:
Gender:F
Credentials:DMD
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Mailing Address - Street 1:CALLE RAFAEL LAMAR 374-A
Mailing Address - Street 2:EXT ROOSEVELT
Mailing Address - City:HATO REY
Mailing Address - State:PR
Mailing Address - Zip Code:00918
Mailing Address - Country:US
Mailing Address - Phone:787-767-7471
Mailing Address - Fax:787-765-9643
Practice Address - Street 1:374 CALLE RAFAEL LAMAR
Practice Address - Street 2:EXT ROOSEVELT
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2117
Practice Address - Country:US
Practice Address - Phone:787-767-7471
Practice Address - Fax:787-765-9643
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2012-12-20
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Provider Licenses
StateLicense IDTaxonomies
PR21481223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics