Provider Demographics
NPI:1790859544
Name:SANCHEZ, ROBERTO (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1755 AVE PAZ GRANELA
Mailing Address - Street 2:URB. SANTIAGO IGLESIAS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-3630
Mailing Address - Country:US
Mailing Address - Phone:787-792-8200
Mailing Address - Fax:787-792-8200
Practice Address - Street 1:1755 AVE PAZ GRANELA
Practice Address - Street 2:URB. SANTIAGO IGLESIAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3630
Practice Address - Country:US
Practice Address - Phone:787-792-8200
Practice Address - Fax:787-792-8200
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice