Provider Demographics
NPI:1629164140
Name:CANALS, MARTA ISABEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARTA
Middle Name:ISABEL
Last Name:CANALS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GRAN BOULEVAR PASEOS
Mailing Address - Street 2:GALERIA PASEOS SUITE 108
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-292-0808
Mailing Address - Fax:787-292-0800
Practice Address - Street 1:100 GRAN BOULEVAR PASEOS
Practice Address - Street 2:GALERIA PASEOS SUITE 108
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-292-0808
Practice Address - Fax:787-292-0800
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1415122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist