Provider Demographics
NPI:1851348585
Name:SANTIAGO, GERARDO (DDS)
Entity Type:Individual
Prefix:DR
First Name:GERARDO
Middle Name:
Last Name:SANTIAGO
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 1:3699 AIRPORT RD N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-8516
Mailing Address - Country:US
Mailing Address - Phone:239-262-3898
Mailing Address - Fax:239-263-1035
Practice Address - Street 1:3699 AIRPORT RD N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-8516
Practice Address - Country:US
Practice Address - Phone:239-262-3898
Practice Address - Fax:239-263-1035
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00138251223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry