Provider Demographics
NPI:1952444218
Name:ANGUEIRA-ABREU, JAVIER (DMD)
Entity Type:Individual
Prefix:
First Name:JAVIER
Middle Name:
Last Name:ANGUEIRA-ABREU
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:PO BOX 604
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:PR
Mailing Address - Zip Code:00690-0604
Mailing Address - Country:US
Mailing Address - Phone:787-830-2060
Mailing Address - Fax:787-830-2253
Practice Address - Street 1:2981 AVE MILITAR STE 1
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-4075
Practice Address - Country:US
Practice Address - Phone:787-830-2060
Practice Address - Fax:787-830-2253
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR25081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice