Provider Demographics
NPI:1730552415
Name:ARROYO, MARIE VANESSA (DMD)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:VANESSA
Last Name:ARROYO
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 1:233 CALLE 8
Mailing Address - Street 2:URB. JARDINES DE TOA ALTA
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953
Mailing Address - Country:US
Mailing Address - Phone:787-390-5634
Mailing Address - Fax:
Practice Address - Street 1:72 CALLE GEORGETTI
Practice Address - Street 2:
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719-3001
Practice Address - Country:US
Practice Address - Phone:787-390-5634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-04
Last Update Date:2016-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR32101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice