Provider Demographics
NPI:1679634620
Name:NIGAGLIONI, DIOSDADA P (DMD)
Entity Type:Individual
Prefix:DR
First Name:DIOSDADA
Middle Name:P
Last Name:NIGAGLIONI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:DIOSDADA
Other - Middle Name:P
Other - Last Name:NIGAGLIONI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:PO BOX 10694
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-0694
Mailing Address - Country:US
Mailing Address - Phone:787-842-8841
Mailing Address - Fax:787-842-8841
Practice Address - Street 1:URB SAN ANTONIO 531
Practice Address - Street 2:CARR GUAYANILLA STE 1
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1791
Practice Address - Country:US
Practice Address - Phone:787-842-8841
Practice Address - Fax:787-842-8841
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2003122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist