Provider Demographics
NPI:1831586296
Name:PAGAN BANCHS, MARGIEZEL (DMD)
Entity type:Individual
Prefix:DR
First Name:MARGIEZEL
Middle Name:
Last Name:PAGAN BANCHS
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 1:2B10 CALLE 54
Mailing Address - Street 2:URB. JARDINES DEL CARIBE
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728-2658
Mailing Address - Country:US
Mailing Address - Phone:787-548-6158
Mailing Address - Fax:
Practice Address - Street 1:GALERIA PROFESIONAL CALLE CONCORDIA
Practice Address - Street 2:8118 OFICINA 107
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717
Practice Address - Country:US
Practice Address - Phone:787-843-4465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-22
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR003190122300000X
PR31901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist