Provider Demographics
NPI:1538456546
Name:RUIZ-FEBO, NELSON (DMD)
Entity Type:Individual
Prefix:DR
First Name:NELSON
Middle Name:
Last Name:RUIZ-FEBO
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:URB.EL MIRADOR DE CUPEY A-6 CALLE 2
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7545
Mailing Address - Country:US
Mailing Address - Phone:787-460-0283
Mailing Address - Fax:
Practice Address - Street 1:VILLA DEL ROSARIO CALLE 2 A-3
Practice Address - Street 2:
Practice Address - City:NAGUABO
Practice Address - State:PR
Practice Address - Zip Code:00781
Practice Address - Country:US
Practice Address - Phone:787-460-0283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101731223X0400X
PR31501223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty