Provider Demographics
NPI:1134893373
Name:HARFUCH CAPDEVILA, TESSIE (DDS)
Entity type:Individual
Prefix:DR
First Name:TESSIE
Middle Name:
Last Name:HARFUCH CAPDEVILA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1093 CALLE 1
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-5128
Mailing Address - Country:US
Mailing Address - Phone:787-484-3830
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF PUERTO RICO, MEDICAL SCIENCES CAMPUS
Practice Address - Street 2:PASEO DR. JOSE CELSO BARBOSA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-0092
Practice Address - Country:US
Practice Address - Phone:787-484-5860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR070-R204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery