Provider Demographics
NPI:1922005263
Name:FRONTERA, BETZAIDA (DMD)
Entity Type:Individual
Prefix:DR
First Name:BETZAIDA
Middle Name:
Last Name:FRONTERA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 PASEO ADRIAN ACEVEDO
Mailing Address - Street 2:
Mailing Address - City:LAS MARIAS
Mailing Address - State:PR
Mailing Address - Zip Code:00670-2113
Mailing Address - Country:US
Mailing Address - Phone:787-827-2782
Mailing Address - Fax:787-827-2782
Practice Address - Street 1:42 PASEO ADRIAN ACEVEDO
Practice Address - Street 2:
Practice Address - City:LAS MARIAS
Practice Address - State:PR
Practice Address - Zip Code:00670-2113
Practice Address - Country:US
Practice Address - Phone:787-827-2782
Practice Address - Fax:787-827-2782
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-01
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice