Provider Demographics
NPI:1184817132
Name:AROCHO - SALGADO, LIS M (DMD)
Entity type:Individual
Prefix:DR
First Name:LIS
Middle Name:M
Last Name:AROCHO - SALGADO
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:LAS CATALINAS MALL
Mailing Address - Street 2:CARIBBEAN CINEMAS SUITE 205
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-5200
Mailing Address - Country:US
Mailing Address - Phone:787-961-8090
Mailing Address - Fax:787-961-8099
Practice Address - Street 1:LAS CATALINAS MALL
Practice Address - Street 2:CARIBBEAN CINEMAS SUITE 205
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-5200
Practice Address - Country:US
Practice Address - Phone:787-961-8090
Practice Address - Fax:787-961-8099
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR26731223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR42542OtherSSS