Provider Demographics
NPI:1538278544
Name:ALEJANDRO-CRUZ, LUIS ANIBAL (DMD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:ANIBAL
Last Name:ALEJANDRO-CRUZ
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:#610 ALDEBARAN ST
Mailing Address - Street 2:URB ALTAMIRA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920
Mailing Address - Country:US
Mailing Address - Phone:787-781-7021
Mailing Address - Fax:787-273-7118
Practice Address - Street 1:#610 ALDEBARAN ST
Practice Address - Street 2:URB ALTAMIRA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920
Practice Address - Country:US
Practice Address - Phone:787-781-7021
Practice Address - Fax:787-273-7118
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2539122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist