Provider Demographics
NPI:1629178702
Name:VALCARCEL, SANDRA (DMD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:
Last Name:VALCARCEL
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 1:130 AVE WINSTON CHURCHILL
Mailing Address - Street 2:STE. 1 PMB 204
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6013
Mailing Address - Country:US
Mailing Address - Phone:787-732-0515
Mailing Address - Fax:787-653-0201
Practice Address - Street 1:14 CALLE RAFAEL LASA
Practice Address - Street 2:
Practice Address - City:AGUAS BUENAS
Practice Address - State:PR
Practice Address - Zip Code:00703-3113
Practice Address - Country:US
Practice Address - Phone:787-732-0515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2011-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2498122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist