Provider Demographics
NPI:1740358944
Name:NEGRON VIVES, JESUS M (DMD)
Entity type:Individual
Prefix:DR
First Name:JESUS
Middle Name:M
Last Name:NEGRON VIVES
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:BOX 794
Mailing Address - Street 2:
Mailing Address - City:JAYUYA
Mailing Address - State:PR
Mailing Address - Zip Code:00664
Mailing Address - Country:US
Mailing Address - Phone:787-828-6400
Mailing Address - Fax:787-828-6400
Practice Address - Street 1:GUILLERMO ESTEVES 103 ALTOS
Practice Address - Street 2:
Practice Address - City:JAYUYA
Practice Address - State:PR
Practice Address - Zip Code:00664
Practice Address - Country:US
Practice Address - Phone:787-828-6400
Practice Address - Fax:787-828-6400
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR925122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist