Provider Demographics
NPI:1861491607
Name:RAMIREZ-FRIAS, CANDIDO (DMD)
Entity Type:Individual
Prefix:
First Name:CANDIDO
Middle Name:
Last Name:RAMIREZ-FRIAS
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 1:203 ST., 4F-26
Mailing Address - Street 2:COLINAS DE PAIRVIEW
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976
Mailing Address - Country:US
Mailing Address - Phone:787-761-0553
Mailing Address - Fax:
Practice Address - Street 1:ST. NO. 6, NO. 1211
Practice Address - Street 2:EXT. SAN AGUSTIN
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-763-6330
Practice Address - Fax:787-763-6330
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR765122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist