Provider Demographics
NPI:1750687695
Name:CORA-CRUZ, LORENA (DMD)
Entity type:Individual
Prefix:DR
First Name:LORENA
Middle Name:
Last Name:CORA-CRUZ
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:ST. A-B #5 URB. SAN ANTONIO
Mailing Address - Street 2:
Mailing Address - City:ARROYO
Mailing Address - State:PR
Mailing Address - Zip Code:00714-2258
Mailing Address - Country:US
Mailing Address - Phone:787-613-2221
Mailing Address - Fax:
Practice Address - Street 1:6 CALLE CORCHADO
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-3518
Practice Address - Country:US
Practice Address - Phone:787-258-4560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2809122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist