Provider Demographics
NPI:1720211535
Name:SOTOMAYOR, LAURAMAR (DMD)
Entity Type:Individual
Prefix:DR
First Name:LAURAMAR
Middle Name:
Last Name:SOTOMAYOR
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 1:1300 CALLE ATENAS # VILLAS
Mailing Address - Street 2:APT 1103
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7807
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1300 CALLE ATENAS # VILLAS
Practice Address - Street 2:APT 1103
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-7807
Practice Address - Country:US
Practice Address - Phone:787-630-0383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2841122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist