Provider Demographics
NPI:1750366738
Name:SANTIAGO-CUMMINGS, JOSE MIGUEL (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:MIGUEL
Last Name:SANTIAGO-CUMMINGS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618TH DENTAL COMPANY (AS)
Mailing Address - Street 2:UNIT #15652
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96205-5652
Mailing Address - Country:US
Mailing Address - Phone:315-737-2600
Mailing Address - Fax:
Practice Address - Street 1:618TH DENTAL COMPANY (AS)
Practice Address - Street 2:UNIT #15652
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96205-5652
Practice Address - Country:US
Practice Address - Phone:315-737-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI249341223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery