Provider Demographics
NPI:1558531012
Name:CADILLA, MARIA B (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:B
Last Name:CADILLA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:MARIA
Other - Middle Name:B
Other - Last Name:CADILLA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:PO BOX 19618
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00910-1618
Mailing Address - Country:US
Mailing Address - Phone:787-536-4261
Mailing Address - Fax:
Practice Address - Street 1:1656 CALLE ADAMS
Practice Address - Street 2:URB. SUMMIT HILLS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-4360
Practice Address - Country:US
Practice Address - Phone:787-786-4133
Practice Address - Fax:787-786-4133
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice