Provider Demographics
NPI:1538156393
Name:CHARNECO, CARMEN RITA (DMD)
Entity type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:RITA
Last Name:CHARNECO
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 1:3KS8 VIA MYRTA
Mailing Address - Street 2:VILLA FONTANA
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983-4639
Mailing Address - Country:US
Mailing Address - Phone:787-276-1185
Mailing Address - Fax:787-276-1185
Practice Address - Street 1:3KS8 VIA MYRTA
Practice Address - Street 2:VILLA FONTANA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983-4639
Practice Address - Country:US
Practice Address - Phone:787-276-1185
Practice Address - Fax:787-276-1185
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice