Provider Demographics
NPI:1881671824
Name:PONS, SILVANA MARIBEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:SILVANA
Middle Name:MARIBEL
Last Name:PONS
Suffix:
Gender:F
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:PO BOX 4223
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00694-4223
Mailing Address - Country:US
Mailing Address - Phone:787-855-6776
Mailing Address - Fax:787-855-6776
Practice Address - Street 1:125 CALLE MARGINAL
Practice Address - Street 2:URB MONTE CARLO
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-4239
Practice Address - Country:US
Practice Address - Phone:787-855-6776
Practice Address - Fax:787-855-6776
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
4 2329OtherSSS
041945OtherCA
206809OtherPREFERRED HEALTH
1706OtherIMC
3514153OtherACAA
6930016OtherHUMANA