Provider Demographics
NPI:1942346523
Name:FIGUEROA ESTASIE, ILVA LUZ (DMD)
Entity Type:Individual
Prefix:
First Name:ILVA
Middle Name:LUZ
Last Name:FIGUEROA ESTASIE
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:PO BOX 3003
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777
Mailing Address - Country:US
Mailing Address - Phone:787-734-4155
Mailing Address - Fax:787-734-4155
Practice Address - Street 1:AVE MUNOZ RIVERA 22
Practice Address - Street 2:
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777
Practice Address - Country:US
Practice Address - Phone:787-734-4155
Practice Address - Fax:787-734-4155
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1855122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist