Provider Demographics
NPI:1720065196
Name:ORTIZ, MAGALI (DMD)
Entity Type:Individual
Prefix:DR
First Name:MAGALI
Middle Name:
Last Name:ORTIZ
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:PO BOX 868
Mailing Address - Street 2:
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794-0868
Mailing Address - Country:US
Mailing Address - Phone:787-857-0514
Mailing Address - Fax:787-857-2860
Practice Address - Street 1:4 CALLE BARCELO
Practice Address - Street 2:SUITE 101
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794-1746
Practice Address - Country:US
Practice Address - Phone:787-857-0514
Practice Address - Fax:787-857-2860
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice