Provider Demographics
NPI:1336212364
Name:SANTIAGO, CRISTINA E (DMD)
Entity Type:Individual
Prefix:DR
First Name:CRISTINA
Middle Name:E
Last Name:SANTIAGO
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:BOSQUE DE LAS PALMAS 247
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:787-396-4837
Mailing Address - Fax:787-780-8065
Practice Address - Street 1:CANTON MALL
Practice Address - Street 2:FA-10
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00952
Practice Address - Country:US
Practice Address - Phone:787-599-2303
Practice Address - Fax:787-780-8065
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2738122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist