Provider Demographics
NPI:1659727238
Name:MALDONADO PLANELL, MARIANA DEL PILAR (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARIANA
Middle Name:DEL PILAR
Last Name:MALDONADO PLANELL
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 1:445 CALLE CALETA
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-2286
Mailing Address - Country:US
Mailing Address - Phone:939-451-2018
Mailing Address - Fax:
Practice Address - Street 1:CARR 628
Practice Address - Street 2:BO SABANA HOYOS SECTOR JOBALES
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00688
Practice Address - Country:US
Practice Address - Phone:787-361-7895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-12
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3302122300000X, 1223G0001X
TX348021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist