Provider Demographics
NPI:1659422442
Name:CADILLA, MARIA TERESA (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:TERESA
Last Name:CADILLA
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:PASEO MAYOR CALLE 5 A - 14
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-755-2903
Mailing Address - Fax:787-293-0266
Practice Address - Street 1:IA5 AVE LOMAS VERDES
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-3133
Practice Address - Country:US
Practice Address - Phone:787-798-6080
Practice Address - Fax:787-995-0459
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice