Provider Demographics
NPI:1902011653
Name:NADAL ARRILLAGA, ALFREDO R (DMD)
Entity Type:Individual
Prefix:
First Name:ALFREDO
Middle Name:R
Last Name:NADAL ARRILLAGA
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 1:65 E MENDEZ VIGO
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:65 CALLE MENDEZ VIGO E
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-4934
Practice Address - Country:US
Practice Address - Phone:787-833-0398
Practice Address - Fax:787-805-0398
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR594122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist