Provider Demographics
NPI:1538229208
Name:ROSADO VALENTIN, JUAN (DMD)
Entity type:Individual
Prefix:DR
First Name:JUAN
Middle Name:
Last Name:ROSADO VALENTIN
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:PO BOX 140550
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-0550
Mailing Address - Country:US
Mailing Address - Phone:787-897-2080
Mailing Address - Fax:787-897-7736
Practice Address - Street 1:URB BUENA VISTA 17
Practice Address - Street 2:CALLE RAMON DE JESUS SIERRA
Practice Address - City:LARES
Practice Address - State:PR
Practice Address - Zip Code:00669
Practice Address - Country:US
Practice Address - Phone:787-897-2080
Practice Address - Fax:787-897-7736
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice