Provider Demographics
NPI:1548321193
Name:MANGUAL-GUTIERREZ, HANS (DMD)
Entity type:Individual
Prefix:DR
First Name:HANS
Middle Name:
Last Name:MANGUAL-GUTIERREZ
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 1:400 AVE. F.D. ROOSEVELT SUITE 512
Mailing Address - Street 2:CLINICA LAS AMERICAS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-2163
Mailing Address - Country:US
Mailing Address - Phone:787-756-6380
Mailing Address - Fax:787-756-6381
Practice Address - Street 1:400 AVE. F.D. ROOSEVELT SUITE 512
Practice Address - Street 2:CLINICA LAS AMERICAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2163
Practice Address - Country:US
Practice Address - Phone:787-756-6380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2022-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR26851223G0001X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No1223G0001XDental ProvidersDentistGeneral Practice