Provider Demographics
NPI:1861458135
Name:JUSTINIANO, ARMANDO (DMD)
Entity Type:Individual
Prefix:DR
First Name:ARMANDO
Middle Name:
Last Name:JUSTINIANO
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 1:116 CALLE DE DIEGO E
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-5030
Mailing Address - Country:US
Mailing Address - Phone:787-834-7730
Mailing Address - Fax:787-834-7730
Practice Address - Street 1:116 CALLE DE DIEGO E
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-5030
Practice Address - Country:US
Practice Address - Phone:787-834-7730
Practice Address - Fax:787-834-7730
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice