Provider Demographics
NPI:1801081047
Name:CORDOVA, MARIA EUGENIA (DMD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:EUGENIA
Last Name:CORDOVA
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:DD16 CALLE 25
Mailing Address - Street 2:RIVERVIEW
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-3804
Mailing Address - Country:US
Mailing Address - Phone:787-780-6261
Mailing Address - Fax:787-778-2217
Practice Address - Street 1:DD16 CALLE 25
Practice Address - Street 2:RIVERVIEW
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-3804
Practice Address - Country:US
Practice Address - Phone:787-780-6261
Practice Address - Fax:787-778-2217
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR27961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice