Provider Demographics
NPI:1144485889
Name:PLAZA, NORBERTO L (DMD)
Entity type:Individual
Prefix:DR
First Name:NORBERTO
Middle Name:L
Last Name:PLAZA
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 1:2 CALLE M
Mailing Address - Street 2:URB SAN CRISTOBAL
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794-1924
Mailing Address - Country:US
Mailing Address - Phone:787-934-1680
Mailing Address - Fax:
Practice Address - Street 1:2 CALLE M
Practice Address - Street 2:URB SAN CRISTOBAL
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794-1924
Practice Address - Country:US
Practice Address - Phone:787-934-1680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054895-1122300000X
PR2899122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program