Provider Demographics
NPI:1548267610
Name:CRUZ ECHEVARRIA, VANESSA THERESA (DMD)
Entity type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:THERESA
Last Name:CRUZ ECHEVARRIA
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 1:328 CALLE MARINA
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-2949
Mailing Address - Country:US
Mailing Address - Phone:787-868-3920
Mailing Address - Fax:787-868-3920
Practice Address - Street 1:328 CALLE MARINA
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-2949
Practice Address - Country:US
Practice Address - Phone:787-868-3920
Practice Address - Fax:787-868-3920
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1399122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist