Provider Demographics
NPI:1619187564
Name:MARQUEZ, RAMON A (DMD)
Entity Type:Individual
Prefix:
First Name:RAMON
Middle Name:A
Last Name:MARQUEZ
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 1:151 CALLE DE DIEGO E
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-5093
Mailing Address - Country:US
Mailing Address - Phone:787-832-5125
Mailing Address - Fax:787-789-7418
Practice Address - Street 1:151 CALLE DE DIEGO E
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-5093
Practice Address - Country:US
Practice Address - Phone:787-832-5125
Practice Address - Fax:787-789-7418
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR002724122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR9690131OtherHUMANA
PR42569MAOtherTRIPLE S