Provider Demographics
NPI:1982616975
Name:LUGO BONET, RAUL E (DMD)
Entity Type:Individual
Prefix:DR
First Name:RAUL
Middle Name:E
Last Name:LUGO BONET
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 CALLE 2
Mailing Address - Street 2:GARDEN HILLS ESTATES
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-2907
Mailing Address - Country:US
Mailing Address - Phone:787-797-4680
Mailing Address - Fax:
Practice Address - Street 1:A9 CALLE 7
Practice Address - Street 2:BAYAMON GARDENS
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957-2517
Practice Address - Country:US
Practice Address - Phone:787-797-4680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR25501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice