Provider Demographics
NPI:1558570499
Name:UCROS, GERMAN ANDRES (DMD)
Entity Type:Individual
Prefix:DR
First Name:GERMAN
Middle Name:ANDRES
Last Name:UCROS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:ANDRES
Other - Middle Name:
Other - Last Name:UCROS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:1 CALLE SAN ANTONIO N
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00784-4719
Mailing Address - Country:US
Mailing Address - Phone:787-864-6865
Mailing Address - Fax:787-864-5856
Practice Address - Street 1:1 CALLE SAN ANTONIO N
Practice Address - Street 2:
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784-4719
Practice Address - Country:US
Practice Address - Phone:787-864-6865
Practice Address - Fax:787-864-5856
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice