Provider Demographics
NPI:1679556021
Name:DONATE, NOEL I (DDS)
Entity Type:Individual
Prefix:
First Name:NOEL
Middle Name:I
Last Name:DONATE
Suffix:
Gender:M
Credentials:DDS
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 2313
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00694-2313
Mailing Address - Country:US
Mailing Address - Phone:787-858-5155
Mailing Address - Fax:787-807-0861
Practice Address - Street 1:CARR 686 1A-1 URB VILLA REAL
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693
Practice Address - Country:US
Practice Address - Phone:787-858-5155
Practice Address - Fax:787-807-0861
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice