Provider Demographics
NPI:1962510263
Name:ROSADO PAGAN, ROY I (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:I
Last Name:ROSADO PAGAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE 25 DE JULIO NO. 42
Mailing Address - Street 2:
Mailing Address - City:GUANICA
Mailing Address - State:PR
Mailing Address - Zip Code:00653-2712
Mailing Address - Country:US
Mailing Address - Phone:787-821-2105
Mailing Address - Fax:787-821-2105
Practice Address - Street 1:42 CALLE 25 DE JULIO
Practice Address - Street 2:
Practice Address - City:GUANICA
Practice Address - State:PR
Practice Address - Zip Code:00653-2712
Practice Address - Country:US
Practice Address - Phone:787-821-2105
Practice Address - Fax:787-821-2105
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-27
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice