Provider Demographics
NPI:1659329282
Name:ITURRINO, LUIS RAUL
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:RAUL
Last Name:ITURRINO
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:PO BOX 1617
Mailing Address - Street 2:
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-1617
Mailing Address - Country:US
Mailing Address - Phone:787-256-3115
Mailing Address - Fax:787-256-3115
Practice Address - Street 1:PALMER ST.
Practice Address - Street 2:
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729-1617
Practice Address - Country:US
Practice Address - Phone:787-256-3115
Practice Address - Fax:787-256-3115
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice