Provider Demographics
NPI:1134274798
Name:VEGA, HIRAM (DMD)
Entity type:Individual
Prefix:DR
First Name:HIRAM
Middle Name:
Last Name:VEGA
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 1:1 A 7 AZALEA ST
Mailing Address - Street 2:ROYAL PALM
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:787-780-3553
Mailing Address - Fax:787-780-6988
Practice Address - Street 1:AZALEA 1 A 7 ROYAL PALM
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-780-3553
Practice Address - Fax:787-780-6988
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14671223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry