Provider Demographics
NPI:1639329832
Name:CACHO, CHRISTIAN C
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:C
Last Name:CACHO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND. IBERIA I, APT. 301
Mailing Address - Street 2:ALTAMIRA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920-2515
Mailing Address - Country:US
Mailing Address - Phone:787-237-7347
Mailing Address - Fax:
Practice Address - Street 1:COND. IBERIA I, APT. 301
Practice Address - Street 2:ALTAMIRA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-2515
Practice Address - Country:US
Practice Address - Phone:787-237-7347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-24
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054070122300000X
PR28081223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist