Provider Demographics
NPI:1659370187
Name:QUILES, RAFAEL (DMD)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:
Last Name:QUILES
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:PO BOX 6827
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-6827
Mailing Address - Country:US
Mailing Address - Phone:787-743-8526
Mailing Address - Fax:787-743-8526
Practice Address - Street 1:202 AVE. JOSE GAUTIER BENITEZ
Practice Address - Street 2:SUITE C-6 (EXTERIOR) CONSOLIDATED MALL
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00726
Practice Address - Country:US
Practice Address - Phone:787-743-8526
Practice Address - Fax:787-743-8526
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7631223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry