Provider Demographics
NPI:1265400774
Name:GIRAU-COLON, LETICIA MARIE (DMD)
Entity type:Individual
Prefix:DR
First Name:LETICIA
Middle Name:MARIE
Last Name:GIRAU-COLON
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 1:399 CALLE TRINITARIA
Mailing Address - Street 2:SABANERA DEL RIO
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-3708
Mailing Address - Country:US
Mailing Address - Phone:787-691-5854
Mailing Address - Fax:787-739-8182
Practice Address - Street 1:2 CALLE FRANCISCO CRUZ
Practice Address - Street 2:
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739-3420
Practice Address - Country:US
Practice Address - Phone:787-739-8182
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR25691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice