Provider Demographics
NPI:1265403083
Name:AVILES RAMOS, ANGEL F (DMD)
Entity type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:F
Last Name:AVILES RAMOS
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:P.O. BOX 1507
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-1507
Mailing Address - Country:US
Mailing Address - Phone:787-735-7960
Mailing Address - Fax:787-735-7960
Practice Address - Street 1:SAN JOSE #155
Practice Address - Street 2:
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-0000
Practice Address - Country:US
Practice Address - Phone:787-735-7960
Practice Address - Fax:787-735-7960
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1191122300000X
NY#053810122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1191OtherSTATE LICENSE