Provider Demographics
NPI:1780791244
Name:IRIZARRY-CARO, TERESA J (DMD)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:J
Last Name:IRIZARRY-CARO
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 1:4 CAMINO ALEJANDRINO
Mailing Address - Street 2:VILLA CLEMENTINA
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-4712
Mailing Address - Country:US
Mailing Address - Phone:787-790-4870
Mailing Address - Fax:787-790-1859
Practice Address - Street 1:4 CAMINO ALEJANDRINO
Practice Address - Street 2:VILLA CLEMENTINA
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-4712
Practice Address - Country:US
Practice Address - Phone:787-190-4870
Practice Address - Fax:787-790-1859
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13551223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics