Provider Demographics
NPI:1245317395
Name:ARBONA, JOSE (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:
Last Name:ARBONA
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 1:2974 AVE EMILIO FAGOT
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-3615
Mailing Address - Country:US
Mailing Address - Phone:787-841-1647
Mailing Address - Fax:787-841-7722
Practice Address - Street 1:2974 AVE EMILIO FAGOT
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-3615
Practice Address - Country:US
Practice Address - Phone:787-841-1647
Practice Address - Fax:787-841-7722
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR041347OtherBLUE CROSS
PR7310189OtherHUMANA DENTAL PLAN PR
PR61581OtherDELTA DENTAL PLAN PR
PR41572OtherDENTAL INSURANCE CO SSS