Provider Demographics
NPI:1912039256
Name:MONTANEZ, EFRAIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:EFRAIN
Middle Name:
Last Name:MONTANEZ
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 1:9 MARIA
Mailing Address - Street 2:CIUDAD JARDIN 3
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-4865
Mailing Address - Country:US
Mailing Address - Phone:787-279-0319
Mailing Address - Fax:787-797-7837
Practice Address - Street 1:167 AVE.
Practice Address - Street 2:URB.MONTANEZ # 11
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957
Practice Address - Country:US
Practice Address - Phone:787-269-7900
Practice Address - Fax:787-786-1865
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice