Provider Demographics
NPI:1982825444
Name:ALVARADO, JOSE ANGEL (DMD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:ANGEL
Last Name:ALVARADO
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 CALLE BARCELO
Mailing Address - Street 2:SUITE301
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794-1779
Mailing Address - Country:US
Mailing Address - Phone:787-857-3381
Mailing Address - Fax:787-857-3381
Practice Address - Street 1:9 CALLE BARCELO
Practice Address - Street 2:SUITE301
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794-1779
Practice Address - Country:US
Practice Address - Phone:787-857-3381
Practice Address - Fax:787-857-3381
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2583122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist