Provider Demographics
NPI:1609914589
Name:LASA-MORALES, RAMON ARNALDO (DMD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:ARNALDO
Last Name:LASA-MORALES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:ARNALDO
Other - Middle Name:
Other - Last Name:LASA-MORALES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:31 MUNOZ RIVERA
Mailing Address - Street 2:
Mailing Address - City:AGUAS BUENAS
Mailing Address - State:PR
Mailing Address - Zip Code:00703
Mailing Address - Country:US
Mailing Address - Phone:787-732-8374
Mailing Address - Fax:787-732-1870
Practice Address - Street 1:21 CALLE BELEN
Practice Address - Street 2:ALTURAS DE SAN PATRICIO
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-3123
Practice Address - Country:US
Practice Address - Phone:787-732-8374
Practice Address - Fax:787-732-1870
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice