Provider Demographics
NPI:1356151187
Name:GIRON, SANTIAGO
Entity type:Individual
Prefix:
First Name:SANTIAGO
Middle Name:
Last Name:GIRON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MITRE 282
Mailing Address - Street 2:
Mailing Address - City:QUILMES
Mailing Address - State:BS AS
Mailing Address - Zip Code:001878
Mailing Address - Country:AR
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:MITRE 282
Practice Address - Street 2:
Practice Address - City:QUILMES
Practice Address - State:BS AS
Practice Address - Zip Code:001878
Practice Address - Country:AR
Practice Address - Phone:689-867-4367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ2341331223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics